CN106999196A - A clot retrieval device for removing occlusive clot from a blood vessel - Google Patents

A clot retrieval device for removing occlusive clot from a blood vessel Download PDF

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Publication number
CN106999196A
CN106999196A CN201580064164.3A CN201580064164A CN106999196A CN 106999196 A CN106999196 A CN 106999196A CN 201580064164 A CN201580064164 A CN 201580064164A CN 106999196 A CN106999196 A CN 106999196A
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CN
China
Prior art keywords
thrombus
portion
apparatus
device
take
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CN201580064164.3A
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Chinese (zh)
Inventor
D·瓦勒
B·凯西
M·吉尔瓦里
J·奥戈尔曼
K·麦卡德尔
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尼尔拉维有限公司
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Priority to US201462084960P priority Critical
Priority to US62/084,960 priority
Application filed by 尼尔拉维有限公司 filed Critical 尼尔拉维有限公司
Priority to PCT/EP2015/077692 priority patent/WO2016083472A1/en
Publication of CN106999196A publication Critical patent/CN106999196A/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320725Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2/013Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stending
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22034Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2217Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/016Filters implantable into blood vessels made from wire-like elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0073Quadric-shaped
    • A61F2230/008Quadric-shaped paraboloidal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0091Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section

Abstract

A clot retrieval device for removal of occlusive clot from a blood vessel comprises a clot engaging element (700) having a constrained delivery configuration and an expanded deployed configuration. In the expanded configuration peripheral portions are laterally spaced-apart and the clot engaging section (700) extends between the peripheral portions. The device (700) may have two superimposed wave patterns provided by a large amplitude curve (723) and shorter pitch sinusoidal patterns (721, 722). A wave shape varies the contact pressure between a clot and the device along the length of the device, reducing the compression of the clot by the device at some locations. The device can elongate when placed under tension which aids elongation of the clot during dislodgement.

Description

从血管除去阻塞性血栓的取血栓装置 Taking means for removing thrombus from the vessel obstructive thrombus

技术领域 FIELD

[0001] 本发明涉及意于从血管除去严重阻塞物的装置。 [0001] The present invention relates to apparatus intended to serious obstruction is removed from the blood vessel. 严重阻塞物可包括血栓、错位的装置、移位的装置、大栓子等。 Severe obstruction may comprise thrombus, misalignment means, shifting means, like a large emboli. 当部分或所有的血栓从血管壁脱开时发生血栓栓塞。 Thromboembolism occurs when part or all of the thrombus from the vessel wall is disengaged. 然后,此血栓(现在称为栓塞物)被在血液流动的方向上携带。 Then, this thrombus (now referred to as emboli) is carried in the direction of blood flow. 如果血栓停留在脑血管中则可能造成缺血性发作。 If you stay in the cerebral vascular thrombosis may result in ischemic stroke. 如果血栓产生在静脉系统中或心脏的右侧中并且停留在肺动脉或其分支中则可能造成肺栓塞。 If the thrombus is generated in the venous system of the heart or the right side and stays in the pulmonary artery or its branches may result in pulmonary embolism. 血栓也可局部地产生和阻塞血管,而不以栓塞物的形式释放-此机理在冠状动脉堵塞的形成过程中是常见的。 Thrombosis may be generated locally and block blood vessels, and not released in the form emboli - this is a common mechanism in the formation of coronary blockage. 本发明特别适合于从患有急性缺血性脑卒中(AIS)的患者的脑动脉中、从患有心肌梗死(MI)的患者的天然或移植冠状血管中、从患有肺栓塞(PE)的患者的肺动脉中以及从在其中血栓导致阻塞的其它周围动脉和静脉血管中除去血栓。 The present invention is particularly suitable for cerebral artery from a patient with acute ischemic stroke (AIS), a natural or transplant coronary blood vessels from patients suffering myocardial infarction (MI) of, suffering from pulmonary embolism (PE) pulmonary artery of the patient and the removal of thrombus from the other peripheral arteries and veins in which the blocking of thrombus formation caused.

发明内容 SUMMARY

[0002]根据本发明,提供了一种从血管除去阻塞性血栓的取血栓装置,其包括具有收缩的运输构型和扩张的展开构型的血栓接合元件,其中该装置的至少一部分具有纵向延伸的波动起伏延伸的边缘。 [0002] According to the present invention, there is provided an apparatus for removing thrombus taken obstructive thrombus from a blood vessel, comprising a transport expanded configuration and an expanded configuration having thrombus contraction engagement element, wherein at least a portion of the apparatus has a longitudinal extension the fluctuating extending edges.

[0003]在一个实例中,所述血栓接合元件具有第一周围部分,第二周围部分,和在第一周围部分和第二周围部分之间延伸的血栓接合部分,其中,在所述扩张构型中,这些周围部分被侧向地间隔开,所述血栓接合部分在这些周围部分之间延伸。 [0003] In one example, the engaging element having a first thrombus peripheral portion, a second peripheral portion, between the first and thrombosis peripheral portion and a second portion extending around the engagement portion, wherein, in said expanded configuration type, these surrounding portions are laterally spaced apart, extending between the portion of the peripheral portion engaging the thrombus.

[0004]在一个实施例中,所述波动起伏延伸的边缘具有类似波浪的形式。 [0004] In one embodiment, the wavy edges extending undulations have a wave form similar. 所述波动起伏延伸的边缘可具有正弦波的形式。 The wavy edges extending undulations may have the form of a sine wave.

[0005]在一个实例中,所述装置具有至少两个波动模式。 [0005] In one example, the device has at least two fluctuation mode. 所述波动模式可彼此叠加。 The fluctuation pattern may be superimposed on each other. 在一个实例中,第一模式具有波长和幅值,第二模式具有比第一模式的波长和幅值大的波长和幅值。 In one example, a first mode having a wavelength and amplitude, the second mode and having a magnitude larger than the wavelength of the first wavelength and amplitude patterns.

[0006]在一个实施例中,取血栓装置包括用于改变波动形状的激活器。 [0006] In one embodiment, the apparatus comprises a take thrombus activator for changing the shape of the fluctuations. 所述激活器可包括至少一个推丝和/或至少一个拉丝。 The activator may comprise at least one push wire and / or at least one drawing.

[0007] 在一个实例中,所述血栓接合元件包括一个或多个血栓抓持特征。 [0007] In one example, the thrombus engagement element comprises one or more gripping features thrombus.

[0008] 在一个实施例中,在所述收缩构型中血栓接合部分是大致扁平的。 [0008] In one embodiment, in the contracted configuration thrombus engaging portion is substantially flat.

[0009] 在所述扩张构型中血栓接合部分可以是曲线形的。 [0009] In the engaging portion of the thrombus the expanded configuration may be curved.

[0010] 在所述扩张构型中血栓接合部分是大致扁平的。 [0010] In the expanded configuration thrombus engaging portion is substantially flat.

[0011]在一个实施例中,在所述收缩构型和扩张构型中血栓接合部分是大致曲线形的。 [0011] In one embodiment, in the expanded configuration and the contracted configuration thrombus engaging portion is a generally curvilinear.

[0012] 在一个实例中,在所述扩张构型中血栓接合部分是螺旋的或涡旋的形式。 [0012] In one example, in the expanded configuration thrombus engaging portion is in the form of a spiral or scroll.

[0013] 在所述扩张构型中血栓接合部分可以是大致S-形的。 [0013] In the engaging portion of the thrombus expanded configuration may be substantially S- shaped.

[0014]在一个实施例中,所述血栓接合元件具有总体上面朝相反方向的两个表面,并且在所述扩张的展开构型中其中一个表面或两个表面能够与血栓接合。 [0014] In one embodiment, the thrombus engaging element has two surfaces of opposite directions generally above, and in which one or both surfaces engageable with thrombus in the expanded deployed configuration.

[0015]在一个实施例中,所述装置包括当该装置处于扩张的展开构型中时限定出用于血液流动的流动通道的一部分。 [0015] In one embodiment, the device comprises means which when in an expanded deployed configuration time fix part of the flow path for the blood flow.

[0016]在一个实例中,所述装置包括近侧部分,远侧部分,和近侧部分和远侧部分之间的血栓接合部分,其中近侧部分相对于血栓接合部分可滑动地移动。 [0016] In one example, the device comprises a proximal portion, a distal portion, thrombosis between the proximal and distal portions and the engagement portion, wherein the proximal portion engaging the thrombus with respect to the moving part slidably. 所述近侧部分可包括可滑动元件,比如领部和从领部伸出的近侧支架,所述血栓接合部分包括近侧轴杆,并且所述领部相对于近侧轴杆可滑动地移动。 The proximal portion may comprise a slidable element, such as collar portion and the proximal stent extending from the collar portion, said engaging portion comprises a proximal thrombus shaft and the collar relative to the proximal portion of the shaft is slidably mobile. 所述近侧部分的支架中的至少一些支架可在向远侧方向上延伸,用于在所述领部相对于近侧轴杆向近侧移动时将血栓至少部分地捕获在血栓接合部分和近侧支架之间。 At least some of the stent proximal portion of the stent may extend in a distal direction when said collar portion for movement relative to the shaft proximally to the proximal thrombus at least partially captured in the engaging portion and the thrombus between the proximal stent.

[0017]在一个实施例中,所述波动模式具有从2.0mm至6.0mm的幅值。 [0017] In one embodiment, the fluctuation pattern having an amplitude of from 2.0mm to 6.0mm. 所述波动模式具有从3 • 0mm至8 • 0_的节距。 The fluctuation pattern having a pitch of from 3 • 0mm to the 8 • 0_.

[0018]在一个实施例中,所述血栓接合部分包括由支架和冠状部限定的多个小室结构, 其中所述支架和/或冠状部中的至少一些被以类似波浪的形式布置,以增强血栓的嵌入。 [0018] In one embodiment, said portion comprising a plurality of cell structures defined by the holder engaging and coronary thrombosis portion, wherein the bracket and / or at least some of the wave-like form are arranged in a crown portion to enhance the embedded thrombus. [0019]在一个实例中,所述装置的血栓接合部分具有包含扁平部分和弯曲部分两者的横向截面。 [0019] In one example, the thrombus part of the device comprising both the transverse cross-section having a flat portion and a curved portion joined.

[0020]在一个实施例中,在所述扩张构型中,所述装置的血栓接合部分的至少一部分相对于纵向轴线呈大致涡旋或螺旋构型。 [0020] In one embodiment, at least a portion of the engagement portion in the expanded configuration, the longitudinal axis of the device for thrombus vortexing or substantially helical configuration. 所述血栓接合部分可还包括远侧管状部分。 The engaging portion may further include a thrombus distal tubular portion. 在管状部分的远侧端处可设置血栓碎片部分。 At the distal end of the tubular portion may be provided thrombus debris fraction.

[0021]在一个实施例中,所述血栓接合部分包括由小室结构元件形成的一对侧轨,多个血栓接合支架元件被连接到所述小室结构元件,所述小室结构元件从由侧轨限定的平面的相反两侧突伸。 [0021] In one embodiment, the thrombus engaging portion includes a pair of rails formed by elements of small cell structure, a plurality of stent thrombosis engagement element is connected to the cell element structure, the cell structure member from the side rails protruding on opposite sides of the plane defined.

[0022]在另一实施例中,所述血栓接合部分包括多个段,相邻的段彼此以约90。 [0022] In another embodiment, the plurality of engaging portions thrombus segments comprises adjacent segments to each other at about 90. 布置。 Arrangement. 所述段中的至少一些段具有扁平形状的横向截面。 At least some of said segments having a transverse section in the shape of a flat cross section.

[0023]在所有实施例中,取血栓装置可包括远侧的血栓碎片保护部分。 [0023] In all embodiments, the device may take the thrombus debris including thrombotic distal protection portion.

[0024]本发明还提供了一种从血管除去阻塞性血栓的方法,包括步骤: [0024] The present invention further provides a process for removing obstructive thrombus from a blood vessel, comprising the steps of:

[0025]提供具有血栓接合部分的取血栓装置,所述血栓接合部分具有纵向延伸的波动起伏延伸的形式,所述装置具有收缩的运输构型和扩张的展开构型; [0025] providing a portion of the apparatus taken thrombus thrombus engagement, the engaging portion has the form of thrombus fluctuating extending longitudinally extending, expanded configuration of said transport means and an expanded configuration having contraction;

[0026] 朝向阻塞性血栓并且跨过阻塞性血栓推进微导管; [0026] and across towards the obstructive thrombotic obstructive thrombus advancing the microcatheter;

[0027]将所述装置装载到微导管内并且将其所述装置进到微导管的远侧部分; [0027] the device is loaded into a microcatheter and it proceeds to the distal portion of the apparatus of the microcatheter;

[0028]展开所述装置以使血栓嵌入;和 [0028] The deployment means embedded thrombus; and

[0029]将所述装置的至少一部分和被捕捉的血栓取出到取出导管内。 [0029] and at least a portion of the captured thrombus extraction device to remove the catheter.

[0030]在一个实施例中,该方法包括在血栓内展开所述装置。 [0030] In one embodiment, the method includes deploying the device within the thrombus.

[0031] 在一些实例中,该方法包括在血栓和围绕着血栓的血管壁的那一部分之间展开所述装置的一部分。 [0031] In some examples, the method includes a portion of the deployment device between the portion of the thrombus and the thrombus around the vessel wall.

[0032] 在一个实施例中,该方法包括在所述装置在血栓内展开之后向近侧拉动所述装置。 [0032] In one embodiment, the method includes pulling the device proximally after the device is deployed within a thrombus.

[0033] 该方法可包括在展开所述装置后延迟向近侧拉动所述装置,以在向近侧拉动所述装置和血栓之前进一步将所述装置嵌入到血栓内。 [0033] The method may comprise after deployment of the device is pulled proximally said delay means to said further means before the device is pulled proximally embedded within the thrombus and thrombus.

[0034] 在一个实施例中,本方法包括在将所述装置取出到取出导管之前将所述装置向近侧拉到更大的血管内。 [0034] In one embodiment, the method includes prior to the extraction device to the device to remove the catheter is pulled proximally within a larger vessel.

[0035] 在一些实例中,该方法包括拧绕所述装置以将所述装置嵌入血栓内。 [0035] In some examples, the method includes means to said threaded about the device is embedded within the thrombus.

[0036]根据本发明,提供了一种用于从血管中除去阻塞性血栓的取血栓装置,其包括血栓接合元件,所述血栓接合元件具有收缩的运输构型和扩张的展开构型,所述血栓接合元件具有第一周围部分,第二周围部分,和在第一周围部分和第二周围部分之间延伸的血栓接合部分,其中,在所述扩张构型中,这些周围部分被侧向地间隔开,所述血栓接合部分在这些周围部分之间延伸。 [0036] According to the present invention, there is provided a device for removing thrombus take obstructive thrombus from the vessel, comprising engaging element thrombosis, expanded configuration and an expanded configuration of the transport element has a constriction engaging the thrombus, the said engaging member having a first thrombotic peripheral portion, a second peripheral portion, and thrombosis about the engagement portion between the first portion and the second peripheral portion extends, wherein, in the expanded configuration, the peripheral portion laterally spaced portions extending between the peripheral portion engaging the thrombus.

[0037]在一个实施例中,在收缩构型中血栓接合部分是大致扁平的。 [0037] In one embodiment, in a collapsed configuration thrombus engaging portion is substantially flat.

[0038]在一个实例中,在扩张构型中血栓接合部分是曲线形的。 [0038] In one example, in the expanded configuration thrombus engaging portion is curvilinear.

[0039]在另一实例中,在扩张构型中血栓接合部分是大致扁平的。 [0039] In another example, in the expanded configuration thrombus engaging portion is substantially flat.

[0040]在一个实施例中,在收缩和扩张构型中血栓接合部分是大致曲线形的。 [0040] In one embodiment, the contraction and expansion configuration thrombus engaging portion is a generally curvilinear.

[0041]在一个实例中,在扩张构型中血栓接合部分具有螺旋或涡旋的形式。 [0041] In one example, in the expanded configuration having a spiral form or the thrombus scroll portion engages.

[0042]在另一实例中,在扩张构型中血栓接合部分具有大致s-形状。 [0042] In another example, having a shape substantially in thrombus engagement s- partially expanded configuration.

[0043]在一个实施例中,所述血栓接合元件具有总体上面朝相反方向的两个表面,并且在所述扩张的展开构型中任一表面能够与血栓接合。 [0043] In one embodiment, the thrombus engaging element has two surfaces of opposite directions generally above, and in the expanded deployed configuration of any of a surface engageable with the thrombus.

[0044]在一个实例中,所述装置包括当该装置处于扩张的展开构型中时限定出用于血液流动的流动通道的一部分。 [0044] In one example, when the apparatus comprising the device in an expanded deployed configuration time fix part of the flow path for the blood flow.

[0045]在一个实施例中,本装置的至少一部分包括波动起伏延伸的边缘。 [0045] In one embodiment, at least a portion of the apparatus comprises an edge extending fluctuating. 该波动起伏延伸的边缘可具有正弦波的形式或其它类似波浪的形式。 The fluctuating extending edge may have the form of a sinusoidal wave form or the like.

[0046]在一个实例中,本装置具有可被叠加的至少两个波动模式。 [0046] In one example, the present has at least two fluctuation mode can be superimposed. 第一模式可具有波长和幅值,第二模式具有比第一模式的波长和幅值大的波长和幅值。 The first mode may have a wavelength and amplitude, the second mode and having a magnitude larger than the wavelength of the first wavelength and amplitude patterns.

[0047]在一个实施例中,本装置包括用于改变波动形状的激活器。 [0047] In one embodiment, the apparatus comprises means for changing the shape of the activator fluctuations. 激活器包括至少一个推/拉丝。 Activator comprises at least one pushing / drawing.

[0048]在一个实例中,血栓接合元件包括一个或多个血栓抓持特征。 [0048] In one example, thrombus engagement element comprises one or more gripping features thrombus.

[0049] 本装置可包括远侧捕捉部分。 [0049] The present apparatus may comprise a distal capturing portion.

[0050]在一个实例中,本装置由形状记忆材料、比如镍钛诺的扁平片材形成。 [0050] In one example, the present apparatus, such as flat sheet is formed from Nitinol shape memory material.

[0051 ]本发明还提供了一种从血管除去阻塞性血栓的方法,包括步骤: [0051] The present invention further provides a process for removing obstructive thrombus from a blood vessel, comprising the steps of:

[0052]提供本发明的取血栓装置; [0052] means to take the thrombus present invention is provided;

[0053]将该装置装载到微导管内,其中该装置处于收缩的运输构型中; [0053] The device is loaded into the microcatheter, wherein the transport means is in the retracted configuration;

[0054] 将微导管推进至阻塞性血栓; [0054] The micro catheter is advanced to obstructive thrombus;

[0055] 展开该装置以捕捉血栓;和 [0055] The deployment device to capture thrombus; and

[0056]将该装置和被捕捉的血栓一起取出到取出导管内。 [0056] with the extraction means and to remove the thrombus capture catheter.

[0057]本装置可在血栓内展开以将血栓固定在本装置和血管壁之间。 [0057] The device can be expanded to thrombus fixed between the unit and the thrombus within the vessel wall. 可替代地,本装置在血栓和围绕着血栓的血管壁的那一部分之间展开。 Alternatively, the present device is deployed between the portion of the thrombus and the thrombus around the vessel wall.

附图说明 BRIEF DESCRIPTION

[0058]本发明从下面参考附图对其一些实施例的描述中能够得到更清楚地理解,这些实施例仅通过例子给出,图中: [0058] The present invention from the following description of some embodiments thereof with reference to the accompanying drawings of the embodiments can be more clearly understood, these examples are given merely by way of example, the drawings:

[0059]图la是本发明的取血栓装置的视图; [0059] FIG. La is a view taken thrombus apparatus according to the present invention;

[0060]图lb是包括远侧碎片保护部分的另一取血栓装置的视图; [0060] FIG lb is a fragmented view of another distal protection portion of the apparatus taken thrombus;

[0061]图2a是图la的装置在血管内的血栓区域中在微导管内的截面图; [0061] FIG 2a is a sectional view of FIG. La thrombosis region within the vessel of the apparatus in the microcatheter;

[0062]图2b是图2a的装置处于扩张的展开构型中的视图; [0062] Figure 2a Figure 2b is a device in an expanded deployed configuration view;

[0063]图2c和2d是微导管的断面图,其中图2a的装置分别以线性定向和圆形定向处于被包裹的构型中; [0063] Figures 2c and 2d is a sectional view of the microcatheter, wherein the apparatus of FIG. 2a are linear and circular directional orientation in the wrapped configuration;

[0064]图3a和此是在血管中展开的取血栓装置的等轴测视图和侧视图; [0064] FIG. 3a isometric view and a side view of this apparatus and taken thrombus in a blood vessel is expanded, and the like;

[0065]图4,5和6是具有各种不同的小室结构形状和切割模式的取血栓装置的视图; [0065] Figures 4, 5 and 6 are views taken thrombus devices have various different shapes and cell structure of the cutting mode;

[0066]图7是取血栓装置的等轴测视图,其中流动腔穿过该装置; [0066] FIG. 7 is taken thrombus isometric view of apparatus in which the flow through the device lumen;

[0067]图8a和8b是具有圆形或u形通道的扁平模式取血栓装置的视图; [0067] Figures 8a and 8b are circular or a flat pattern view of the u-shaped channel of the apparatus taken thrombus;

[0068]图9和10是具有流动通道的其它取血栓装置的视图; [0068] FIGS. 9 and 10 are views taken thrombus other devices having a flow passage;

[0069]图11a至d示出另一取血栓装置,其一部分具有扁平构型; [0069] Figures 11a to d show another means to take the thrombus, a portion having a flat configuration;

[0070]图12和13示意出具有螺旋形状的取血栓装置; [0070] FIGS. 12 and 13 illustrate apparatus taken thrombus having a spiral shape;

[0071]图14a,14b和15示意出具有远侧保护部分的另一螺旋形装置; [0071] FIG. 14a, 14b and 15 illustrate another distal protection device having a helical portion;

[0072]图16示意出另一取血栓装置,其被沿着该装置的长度拧绕; [0072] Figure 16 illustrates a further means to take the thrombus, which is threaded along the length of the device around;

[0073]图17a是本发明的另一取血栓装置的等轴测视图; [0073] Figure 17a is another apparatus of the present invention taken isometric view of a thrombus;

[0074]图17b是图17a的装置的一部分的断面图; [0074] FIG 17b is a cross-sectional view of a portion of the device 17a;

[0075]图17〇至6示出在使用过程中的图17a和b的装置; [0075] FIG 17〇 to 6 show the apparatus of FIG. 17a and b during use of;

[0076]图18a和18b示意出具有流动通道的其它取血栓装置,其中小室结构模式和支架的细节被省略; [0076] Figures 18a and 18b illustrate another apparatus having taken thrombus flow channel, wherein the patterns and the details of the stent cell structure is omitted;

[0077]图19a-19c示意出波状边缘与管状的s-形或u-形中心部分相结合的取血栓装置; [0078]图20示出具有s-形横截面的、沿着装置长度旋涡形延伸的取血栓装置; It means taking thrombosis [0077] FIGS. 19a-19c illustrate the undulating edge of the tubular-shaped or u- s- shaped central portion in combination; [0078] FIG. 20 shows a s- shaped cross-section, along the length of the swirl means means extending taken thrombosis;

[0079]图21a_21c是具有扁平中间部分的另一取血栓装置的视图; [0079] FIG 21a_21c another with flat intermediate section view taken on thrombus apparatus;

[0080]图21 d示出图2 la的装置的碎片保护区域; [0080] FIG. 21 d shows a splinter protection area of ​​the apparatus of FIG. 2 la;

[0081]图21e示出图21a的装置的中间部分的一部分; [0081] FIG. 21e shows a part of the intermediate portion 21a of the apparatus of FIG;

[0082]图22a_22c是根据本发明的另一装置的血栓接合部分的等轴测视图、平面图和侧视图; [0082] FIG 22a_22c is part isometric view, a plan view and a side view of another device engaging thrombomodulin according to the present invention;

[0083] 图23a和23b是取血栓装置在使用过程中的示意图; [0083] Figures 23a and 23b are schematic thrombus apparatus taken during use;

[0084] 图24a_24c是本发明的另一取血栓装置的视图; [0084] FIG 24a_24c is another view of the invention apparatus taken thrombus;

[0085] 图25a_25c是本发明的另一取血栓装置的视图; [0085] FIG 25a_25c is another view of the invention apparatus taken thrombus;

[0086] 图26a_26d示意出本发明的取血栓装置的使用方法; [0086] FIG 26a_26d schematically a method using a pick thrombus apparatus according to the invention;

[0087]图27a_27d是示意性波形装置的一系列视图; [0087] FIG 27a_27d is a schematic view of a series of waveforms device;

[0088] 图28a_28c是取血栓装置的等轴测视图、侧视图和平面图; [0088] FIG 28a_28c apparatus is taken thrombus isometric view, a side view and a plan view;

[0089] 图29a和29b是本发明的另一取血栓装置的平面图和断面图; [0089] FIGS. 29a and 29b of the present invention is another plan view and a sectional view taken thrombus device;

[0090]图30a_30f示意出本发明的另一取血栓装置的使用方法; [0090] FIG 30a_30f schematically illustrating another method of the present invention using the apparatus taken thrombus;

[0091]图31是另一取血栓装置的等轴测视图; [0091] FIG. 31 is another means to take thrombus isometric view;

[0092]图32a和32b分别是本发明的另一取血栓装置的等轴测视图和侧视图;和[0093] 图33a和33b分别是本发明的另一取血栓装置的等轴测视图和侧视图。 [0092] Figures 32a and 32b respectively, another apparatus of the present invention taken thrombus isometric view and a side view; and [0093] FIGS. 33a and 33b respectively, another apparatus of the present invention taken thrombus isometric view and side.

具体实施方式 Detailed ways

[0094]现在参考附图详细描述本发明的特殊实施例,图中相同的参考数字代表相同或功能类似的元件。 [0094] Now embodiments of particular elements of the present invention are described in detail with reference to the drawings, the same or similar functions identical reference numerals in FIG. 在下文中术语“远侧”或“近侧”在提到相对于治疗医生的位置或方向时使用。 The term "distal" or "proximal" when used in reference to a position or direction relative to the treating physician hereinafter. “远侧”或“远侧地”是距医生一距离处的或在远离医生的方向上的一位置。 "Distal" or "distally" are at a distance from the doctor or a position in the direction away from the doctor. “近侧”或“近侧地”或“靠近”是医生附近的或在朝向医生的方向上的一位置。 "Proximal" or "proximally" or "near" is a position close to the doctor or the doctor in the direction of.

[0095]访问脑部血管、冠状动脉血管和肺部血管涉及使用许多从商业上获得的产品和传统的手术步骤。 [0095] access to the brain blood vessels, coronary blood vessels and pulmonary vessels involved in many commercial products obtained from traditional surgical procedures and use. 诸如引导丝、引导管、血管造影术导管和微导管等的访问用产品是已知的并且通常被用于导管实验室程序中。 Such as a guide wire, the guide tube, and accessed angiographic catheter microcatheter with such products are known and typically used in a catheter laboratory procedures. 在下面的描述中,这些产品和方法与本发明的装置和方法结合使用,但不详细描述。 In the following description, in conjunction with these products and methods of the present apparatus and method of the invention, but not described in detail.

[0096]下面的详细描述在本质上仅仅是示例性的,不意于限制本发明或本发明的应用和用法。 [0096] The following detailed description is merely exemplary in nature and not intended to limit the invention or the application and uses of the present invention. 虽然对本发明的描述在许多情况下是在颅内动脉治疗的情境中进行的,但本发明也可用于其它身体通道中。 While the description of the present invention is carried out in the context of the treatment of intracranial arteries, in many cases, but the present invention is also applicable to other body passageway.

[0097]此处公开的装置的可扩张构件希望由在从高度收紧的运输构型中松开时能够自动恢复其形状的材料制成。 [0097] The apparatus disclosed herein, the expandable member is made of a desired material is released from a height of tightening transport configuration to automatically recover its shape. 超弹性材料、比如镍钛诺或具有类似性能的合金是特别适合的。 Superelastic materials such as Nitinol or alloys having similar properties are particularly suitable. 此材料可具有许多形式,比如丝或带或片或管。 This material may have many forms, such as wire or strip or sheet or a tube. 特别适合的制造过程是激光切割镍钛诺管、 然后热定型并电解抛光形成的结构,以制成支架和连接元件的框架。 Particularly suitable manufacturing process is laser cut Nitinol tube, and then heat set and electrolytic polishing structure is formed, to form the frame holder and the connecting element. 此框架可以是如在这里公开的宽泛形状范围中的任一种,并且可以通过添加合金元件(比如铂)或通过各种其它涂层或标记带而使其在荧光透视下可见。 This frame may be any of a wide range of shapes, such as herein disclosed, and by adding alloying elements (such as platinum) or labeled by a variety of other coating or belt to make it visible under fluoroscopy.

[0098] 如在我们的W02012/120490A中描述的,对血栓的压缩可以改变血栓的性能并且通过使其更坚硬且更“粘性”而使血栓更不容易取出,该文献的整体内容被以引用方式并入本文。 [0098] As described in our W02012 / 120490A in compression can alter the properties of thrombus and thrombus by making it harder and more "sticky" the less likely thrombus removed, the entire contents of which is incorporated by reference incorporated herein. 本发明的装置是通过以下述方式在血栓和血管壁之间扩张而促进血栓取出:使一些或所有的血栓从血管分层,在相当大的表面积上与血栓接合,以及以对血栓的压缩最小的方式来进行上述操作。 The present invention is described below by way of expansion between the vessel wall and thrombosis promote thrombosis taken: some or all of the thrombus from the vessel layered, thrombus engagement over a substantial surface area, and to minimize compression of the thrombus manner to the above operation. 对血栓的压缩是最小的,因为本装置不需要显著地移动血栓来进行扩张和与它接合。 Compression thrombosis is minimal, because the present device does not need to significantly move the thrombus expand and engage with it. 相反,本装置利用血栓自身和血管壁的约束来引导其扩张,在此分界区域内扩张。 In contrast, the present device utilizes its own constraints and thrombosis of the vessel wall to guide its expansion, this expansion in the boundary area.

[00"]在最简单的形式中,本装置的、不受约束的血栓接合部分具有朝向大致相反方向的两个表面。当此血栓接合部分在阻塞部内展开时受到血栓和血管壁的约束,因此必须采用弯曲的形状来扩张。此弯曲的形状可被认为是具有内面(抵靠着血栓)和外面(抵靠着血管壁)。当通过微导管被传输到目标部位时,本装置的定向可能不为使用者所知晓,因而可能不在它们的控制能力范围内。此设计的优势在于本装置的任一表面都可成为所述内表面或外表面,从而使得本装置实际上是可逆的。 [00 "] In the simplest form, the device, thrombus unconstrained portions of the two facing surfaces having a substantially opposite direction of the joint. When this thrombotic obstruction engaging portion partially deployed within the vessel wall and thrombosis to be bound, and and it must have a curved shape to expand this curved shape may be considered as having an inner surface (against thrombosis) and outside (against the vessel wall). when transmitted through a microcatheter to the target site, the orientation of the device may not be known to the user, and thus may not be within their range of control. the advantage of this design is that either surface of the device may be the inner or outer surface, so that this unit is in fact reversible.

[0100] 此扁平装置可包括压缩血栓区域以形成横跨血栓的血流通道的部分。 [0100] This device may include a flat region to form a partially compressed thrombus blood flow path across the thrombus. 此通道用于两个重要目的:1)其减小横跨血栓的压力梯度,从而减小为了撤出血栓而必须克服的力之一,和2)其提供了使氧化的、携带着营养的血到达血栓远侧的缺血区域的流通路径。 This channel is used for two important purposes: 1) it reduces the pressure gradient across the thrombus, thereby reducing the force required for the withdrawal of one of the thrombus must be overcome, and 2) it provides the oxidation, carrying nutrients blood flow path reaches the ischemic region distal thrombus. 此部分可包括比如在图7,9,10中示出的管状或圆筒形形状,或在图19中示出的部分圆筒形或“U” 形,或使血栓的离散部分被移动以制造从血栓的近侧到血栓的远侧端的无血栓通道的其它形状。 This portion may comprise a tubular or cylindrical shape such as illustrated in FIG 7,9,10, or shown in Figure 19, a cylindrical portion or "U" shape, or thrombus is moved to discrete portions other shapes for producing non-thrombogenic passage from the proximal to the thrombus distal end of the thrombus.

[0101] 在这里描述的所有装置可还包括远侧碎片捕捉部分,比如在图1,9,12和14中示出的。 [0101] All devices described herein may further comprise a distal portion of the capture debris, such as illustrated in FIGS. 1,9,12 and 14. 理想地,此部分被配置在血栓的远侧以防止在取出过程中可能释放出的任何血栓碎片向远侧移动。 Ideally, this distal portion is configured to prevent thrombus may be released during removal of the thrombus debris any movement distally.

[0102]图la示出本发明的取血栓系统1〇〇包括血栓接合本体101,血栓接合本体101在其近侧端被连接到轴杆102并且在其远侧端被连接到碎片保护部分113。 The system of the present invention taken thrombosis [0102] FIG la shows 1〇〇 engagement body 101 includes a thrombus, thrombus engagement body 101 is connected at its proximal end to the shaft 102 and is connected at its distal end to the debris protection portion 113 . 血栓接合本体包括轴向支架105和横支架107构成的框架,其中横支架包括近侧连接点108和远侧冠状部106。 Thrombosis engaging body includes a frame 105 and constituting an axial cross-holder bracket 107, which bracket comprises a cross-connection point of a proximal portion 108 and distal crown 106. 在其它实施例中,可采用可替代设计的血栓接合本体,比如在图3至1 〇中示出的。 In other embodiments, alternative designs may be employed thrombus engagement body, such as shown in FIGS. 3-1 in the square. 在本例子中, 碎片保护部分113包括支架框架1〇3和纤维基质1〇4。 In the present example, fragments of the protective portion 113 and includes a support frame 1〇3 1〇4 fibrous matrix. 在自由扩张的构型中血栓接合本体101 的形状总体上是扁平的。 In the expanded configuration consisting of thrombosis shape engaging body 101 is generally flat. 本装置当在血管中被展开时具有内侧和外侧,其中内侧112与血栓接触而外侧111背离血栓。 This device has an inner side and outer side when deployed in a vessel, wherein the inner 112 and outer 111 into contact with the thrombus departing thrombosis. 该装置的展开定向决定了哪一侧与血栓接触而哪一侧背离血栓。 Expand the orientation of the device determines which side of the thrombus which side facing away from the contact with the thrombus. 本装置的这两侧是类似的,使得在不影响装置性能的情况下任一侧都能够被展开成与血栓接触。 This means that both sides are similar, so that without affecting the performance of the device can be deployed on either side in contact with the thrombus. 血栓接合本体的材料可以是镍钛诺或类似的超弹性或伪弹性合金,或者可以是不锈钢或者弹性应变足以允许在从微导管展开时恢复原状的其它材料。 Thrombus material bonded body may be similar or nitinol superelastic or pseudo-elastic alloy, or may be a stainless steel or other elastic strain sufficient to allow the restitution of the material when deployed from the microcatheter. 该材料可由扁平材料片或由管进行激光切割、然后进一步处理成扁平状。 The material may be flat sheet material or laser cutting a tube, and then further processed into a flat shape.

[0103]图2a示出经过血管U5中的阻塞性血栓的110的截面图,微导管1〇9已经穿过血管125。 [0103] Figure 2a shows a cross-sectional view through the vascular obstructive thrombus in U5 110, 1〇9 microcatheter 125 has passed through the vessel. 血栓切除术装置100被示出在微导管109中处于其折叠的运输构型中。 Thrombectomy apparatus 100 is shown in its folded transport configuration in the microcatheter 109. 为了引入本装置,首先,按照标准介入程序使引导丝和微导管109横跨过血栓或血块11〇。 To introduce this apparatus, firstly, in accordance with standard interventional procedures microcatheter and the guide wire 109 through the thrombus or clot 11〇 across. 然后,去除引导丝,留下按照标准程序引入的本装置。 Then, the guide wire is removed, leaving the unit introduced according to standard procedures. 本装置的扁平形状允许其顺从着血管的周围而在血栓和血管壁之间扩张,如图2b中示出的,使本装置在展开后形成'u'形形状,血栓接合本体的内侧112面对着血栓并且与其接合,血栓接合本体的外侧111面朝血管壁。 Flat shape of the device allows it to be compliant with perivascular expansion between the vessel wall and thrombosis, shown in Figure 2b, the forming apparatus of the present 'u' shape after expansion, thrombus engagement body inner surface 112 and engaged therewith against thrombosis, thrombosis engaging body 111 facing the outside of the vessel wall. 将本装置定位于血栓和血管壁之间减小了血栓和血管壁之间的接触面积,减小了血栓和血管壁之间的接合,以及减小了后续从血管驱出血栓所需要的力。 This device is positioned between the thrombus and the blood vessel wall reduces the contact area between the vessel wall and thrombosis, reduced engagement between vessel wall and blood clots, and decreasing the driving force from the vessel subsequent thrombus desired . 这样,通过回撤本装置,血栓能够被移出和取回到在近侧定位的导管或鞘管(sheath),如果需要的话借助于吸气进行。 Thus, by this means retracement, thrombi can be removed and taken back proximally positioned catheter or sheath (sheath), if desired, be by means of suction. 可替代地,微导官或中间导官可被向如移动,以部分地重新銷装(resheath)本装置,使装置100的小室结构(cell)模式(pattern)闭合,将血栓夹在支架之间,改进了本装置和血栓之间的抓持。 Alternatively, the microvias officer or the intermediate guiding officer may be as moved to, to partially re-pinned (resheath) this means that the cell structure of the apparatus 100 (cell) mode (pattern) is closed, thrombus sandwiched holder of between improved grip between the present apparatus and thrombosis. 在重新鞘装过程中,“U”形状的臂也可以朝向血栓弯曲,以增强本装置在血栓上的抓持并且便于取出。 In the process of re-loading the sheath, "U" shaped arm may be bent toward the thrombus in order to enhance the grip on the unit and facilitate removal of the thrombus. 本装置和血栓可被重新鞘装并且通过中间导管完全除去,或者被局部重新鞘装的本装置和血栓可利用中间导管撤回到在近侧定位的引导管或鞘管。 The present apparatus and thrombus can be removed and re-fitted sheath completely through the intermediate conduit or sheath is partially re-installed using the present apparatus and thrombosis may be withdrawn to the intermediate conduit positioned proximally of the guide tube or sheath. 这可借助于或不借助于吸气进行。 This may be performed with or without the aid of suction.

[0104]血栓接合本体的远侧端可被连接到或一体至碎片保护部分丨13,如图ib中所示。 [0104] The distal end of the thrombus engagement body may be connected to or integral to the protection portion Shu debris 13, as shown in FIG ib. 在自由扩张的构型中,碎片保护部分可以是扁平的、管状的、锥形形状的或不规则形状的,并且可以是大致平面的或占用一大部分以形成“3D”过滤本体,比如在图21d中示出的网结构。 In the configuration, the free expansion of the debris protective portion may be flat, tubular, tapered shape or an irregular shape, and may be substantially planar or to form a large footprint "3D" filter body, for example, in the mesh structure shown in FIG. 21d. 在血管内的展开构型中,本部分提供捕捉栓塞物碎片、防止它们在血流中释放的一种方式。 In the deployed configuration within a blood vessel, this section provides capture emboli fragments, a way to prevent their release in the bloodstream. 碎片保护部分可由下述构造而成:本装置的各支架,带线图案的、编结或编织的纤维,聚合物膜,或捕获栓塞物碎肩、同时仅部分地限制血流的其它材料。 Splinter protection portion may be constructed of the following: the supports of the present apparatus, braided or knitted fabric strip line pattern, a polymer film, or capture emboli broken shoulder, while only partially restrict blood flow to other materials.

[0105]在图la示出的实施例中,血栓接合本体101由沿着本装置的长度重复的小室结构模式107形成,并且在自由扩张的构型中是扁平的。 [0105] In the embodiment shown in FIG. La, thrombus engagement body 101 formed along the length of the repeating apparatus of the present cell structure pattern 107, and is flat in the configuration of the free expansion. 切割模式可包括各种各样的小室结构形状和不连接的冠状部。 Cutting mode may include a variety of shapes and cell structure are not connected to the crown portion.

[0106]图2c和2d示出了图2a的微导管和所包裹的装置的详细截面图。 [0106] Figures 2c and 2d shows a detailed sectional view of FIG. 2a microcatheter and the wrapping device. 当本装置处于此折叠的构型中时,血栓接合本体可以以图2d中所示的圆形定向127被包裹,或者本装置可被包裹为使各支架以图2c中所示的线性定向126排列。 When the present apparatus is in this folded configuration, the engagement body thrombus 127 may be wrapped round the orientation shown in Figure 2d or the unit may be wrapped such that each of the rack in a linear orientation as shown in FIG. 2c 126 arrangement. 此折叠的线性定向可促使本装置以线性方式扩张,便于本装置在血栓和血管壁之间扩张。 This linear orientation may cause folding apparatus of the present expansion in a linear manner, the present apparatus facilitates expansion between the vessel wall and thrombosis.

[0107]图3a (以等轴测视图)示出本装置的实施例,即使当在血管中展开时本装置也维持扁平形状。 [0107] FIG. 3a (isometric view) shows an embodiment of the present apparatus, even when deployed in a vessel of the present apparatus maintains a flat shape. 此图示出扁平装置150在血管151中展开并且被定位在阻塞性血栓152下面。 This figure shows the flat device 150 deployed in a vessel 151 and is positioned below 152 obstructive thrombus. 本装置的扁平部分154被连接到近侧轴杆153,以便于本装置的引入和取出。 Flat portion of the device 154 is connected to the proximal shaft 153, and in order to remove the introduction of the present apparatus. 扁平部分154由支架158和小室结构159的模式构成,它们与血栓接合并且被嵌入血栓中。 Flat portion 154 is constituted by the bracket 158 ​​and 159 of the cell structure pattern, they engage the thrombus and is embedded in the thrombus. 使用扁平装置可改进血栓的抓持和从血管除去的性能,因为血栓没有被本装置很大程度地压缩,这与沿着血栓的长度施加径向力的管状装置不同。 Use of a flat device may improve performance and gripping thrombus removed from the vessel, since thrombus is not compressed largely present apparatus, which is different from the tubular means for applying a radial force along the length of the thrombus.

[0108]图3b示出图3a中示出的装置和血栓的侧视图。 [0108] Figure 3b shows a side view of the apparatus shown in 3a and thrombus. 在此视图中,扁平装置156的支架155被示出为嵌入血栓152中。 In this view, the flat bracket means 155,156 are shown embedded in the thrombus 152. 此嵌入致使血栓的部分157突伸穿过本装置的小室结构,改进了本装置在血栓上的抓持。 Projecting portion 157 extends through the cell structure of the present apparatus causes this embedded thrombosis, improves the grip of the device on the support thrombosis. 本视图说明了本装置要实现在血栓上的良好抓持并不需要太大的血栓压缩。 This view illustrates the present apparatus to achieve a good grip on the thrombus does not require too much compression thrombosis.

[0109] 支架嵌入的水平和血栓突伸到本装置小室结构内的水平影响本装置能够施加在血栓上的抓持水平。 [0109] embedding the stent protrudes into the horizontal level and thrombus within the cell structure of the present apparatus can be applied to affect the device on the grip level of the thrombus. 本装置的切割模式,比如支架宽度、长度、小室结构形状和尺寸、冠状部内径、浮动冠状部设计,所有这些都影响支架嵌入血栓中的水平。 Cutting mode of the apparatus, such as bracket width, length, shape and size of cell structure, the inner diameter of the crown portion, the crown portion a floating design, all of which affect the level of embedded stent thrombosis. 图4,5和6示出了具有不同的小室结构形状和切割模式的不同实施例。 4, 5 and 6 illustrate different embodiments having a different shape of cell structure and the cutting mode. 图4示出具有许多不相连的浮动冠状部178的扁平装置175。 Figure 4 shows a device 175 having a number of flat floating crown portion 178 are not connected. 图5示出类似的扁平装置200,除了中心冠状部通过“脊骨”支架208连接到一起之外。 FIG. 5 shows a similar flat apparatus 200, in addition to the central crown portion of the "backbone" being connected to the bracket 208 together. 图6示出扁平装置的另一反复结构,其具有沿着扁平装置225的长度连接的多个小室结构229。 FIG 6 shows another structure of repeated flat means having a plurality of cell structure length of the connection device 225 along a flat 229.

[0110] 在图7中示出的另一实施例中,扁平模式与管状的中间部分252结合,管状的中间部分252提供了在血栓中初始展开时穿过本装置的流动腔。 [0110] Example, the flat pattern 252 in combination with the intermediate tubular portion in another embodiment shown in FIG. 7, the intermediate portion 252 of the tubular chamber provides a flow through the device when present in the initial deployment thrombus. 此流动腔252可通过一体的或通过单独的管状部件形成。 This flow chamber 252 may be formed integrally or by a separate tubular member through. 展开时,在流动腔的每一侧,本装置的扁平部分仍在血栓和血管壁之间扩张。 When deployed, the flow chamber on each side of the expansion device between the flat part of the vessel wall still thrombus. 图8a和8b示出可替代的扁平模式275,其可以被热设定而形成本装置中的圆形或U形通道288。 Figures 8a and 275, which may be heat set 8b shows an alternative form of a flat pattern of the present apparatus in circular or U-shaped channel 288. 这可以通过在热处理之前将本装置夹紧在夹具285中实现,比如在图8b中示出的。 This can be done before the heat treatment in the present apparatus the clamping jig 285 is implemented, such as shown in Figure 8b. 图中示出用于外部扁平部分281的小室结构模式280具有与用于中心U通道279的小室结构模式不同的小室结构尺寸和形状,以使在展开时血栓阻挡中心通道中的血流的危险小室结构模式,并且提高装置的灵活性。 Is shown cell structure pattern for the outer flat portion 281 280 has a cell structure pattern a central U-channel 279 different cell structure size and shape, so that the risk of thrombosis blocking the central passage of the blood flow when deployed cell structure pattern, and increase the flexibility of the device.

[0111]图9示意出装置300,其在设计上非常类似于图7的装置250,但另外包括远侧网状部件3〇1。 [0111] Figure 9 illustrates an apparatus 300 which is very similar in design device 250 of FIG. 7, but additionally including a distal 3〇1 mesh member. 此远侧网状部件可被附接到管状中间部分302的远侧端或附接到连接构件303,连接构件3〇3延伸穿过管状构件并且连接到近侧细长轴杆304。 This net distal tubular member may be attached to the distal end of the intermediate portion 302 or 303 attached to the connection member, the connection member extending through the tubular member 3〇3 and connected to the elongated shaft 304 proximally. 此远侧网状部件301可由一个或多个单纤维丝或纤维形成,该纤维可以是单纤维丝或多纤维丝,并且此远侧网状部件301 可以是高强度聚合物材料的,比如超高分子量聚乙烯(UHMWPE),液晶聚合物(LCP),聚乙烯(PE),聚乙二醇对苯二甲酸酯(PET),聚酰胺(PA),酸乙二酯(PEN)或芳族聚酰胺,或可以是金属材料的。 This distal member 301 may be a net or a plurality of monofilaments or fibers, the fibers may be monofilament or multifilament yarn, and this distal member 301 may be a web of high strength polymeric material, such as ultra- high molecular weight polyethylene (UHMWPE), liquid crystal polymer (LCP), polyethylene (PE), polyethylene terephthalate (PET), polyamide (PA), ethylene acid ester (PEN) or aryl aramid, or it may be a metallic material. 如果是金属材料的,那么纤维或细丝优选由形状记忆或超弹性材料比如镍钛诺形成,使得它们可以从在微导管内的压缩构型恢复,而形成直径近似等于本装置在其中被展开的血管的直径的浓密网,以防止血栓碎片向远侧移动。 If a metallic material, the fibers or filaments, such as nitinol preferably formed from a shape memory or superelastic material, such that they can be recovered from the compressed configuration within the microcatheter, and a diameter approximately equal to the unit where it is deployed the dense network of blood vessel diameter, blood clots to prevent debris moved distally.

[0112]在图10中示出的实施例中,本装置由提供流动腔的中心管状部件321与沿着本装置的长度的各径向伸出臂327结合而构成。 [0112] In the illustrated embodiment, the present apparatus provides a flow chamber with a central tubular member 321 of each arm extends radially along the length of the present apparatus in conjunction with FIG. 10 327 constituted. 这些径向伸出臂327通过连接构件325而被连接到近侧轴杆324,并且在连接点322处连接到纤维或丝323并且在展开时在血栓和血管壁之间扩张,减小血栓和血管壁之间的摩擦。 The radially extending arms 327 are connected by connecting member 325 to the proximal shaft 324 and is connected to the connection point 322 to 323 fibers or filaments between a thrombus and expanded vessel wall upon deployment, reducing thrombosis, and friction between the wall of the blood vessel. 在撤回过程中,这些纤维提供与血栓的附加接合并且帮助抓持血栓和从血管驱出血栓,将血栓取出至近侧的导管或鞘管。 In the recall process, the fibers provide additional engagement with the thrombus and thrombus assist in grasping and expelled from the vessel thrombosis, thrombus withdrawn to the proximal catheter or sheath. 此图还示出本装置上的近侧轴杆324和远侧的射线透不过的末端328。 This figure also shows the proximal and distal shaft 324 of the apparatus of the present radiopaque tip 328.

[0113]在图11a-d示出的本装置的另一实施例中,装置355的扁平部分通过将管状装置的一部分热设定成扁平构型而形成,见图lib。 [0113] embodiment, the apparatus of the flat portion 355 is formed by the tubular portion of the heat setting apparatus in a flat configuration in another embodiment of the apparatus shown in FIG. 11a-d, shown in Figure lib. 本装置被热设定成扁平构型的部分可与本装置的管状部分或锥形部分相邻或在两个管状部分之间,或是本装置的整个长度。 This device is heat set into a flat configuration between the two portions of the tubular portion, or the entire length of the apparatus or may be adjacent to the tubular portion or a tapered portion of the device. 此形成方法可导致扁平部分包含2层支架和冠状部370和371。 This method can result in formation of two layers comprising a flat portion and a crown portion 370 and bracket 371. 本装置354在弄平前的切割模式可被配置成使得在重新成形为扁平构型之后这两层具有相同的支架模式,其中支架和冠状部在顶部和底部对齐。 This flattening means 354 in front of the cutting mode may be configured such that the two layers have the same pattern of the stent after the reshaping into a flat configuration, wherein the stent crown portion and the top and bottom aligned. 可替代地,支架模式可被设计成使支架不对齐,而是留出血栓嵌入到支架372 之间的空间。 Alternatively, the stent may be designed such that the pattern is not aligned with the stent, but remained thrombus fitted into the space between the bracket 372. 这允许在本装置被撤回或部分重新鞘装到中间导管、引导管或微导管内时这些支架夹住血栓,见图11c。 This allows the unit to be withdrawn or partially re-attached to the intermediate catheter sheath, or within the guide tube when these stents sandwiching a microcatheter thrombosis, shown in Figure 11c. 血栓被支架夹住增大了本装置在血栓上的抓持并且提高了本装置驱出困难血栓的能力。 Increased thrombus holder clamped in the gripping device of the present thrombosis and improve the ability of the present apparatus expelled difficult thrombosis. 此构建方法便于扁平部分355与管状的356和锥形形状的358远侧碎片保护部分相结合。 This construction method facilitates the flat portion 355 and 358 of the tubular portion 356 and a distal splinter protection combination tapered shape.

[0114]在图I2和13中示出的本装置的另一实施例中,装置400被形成为螺旋形状,其中装置的本体在血管内顺从地延伸,所以沿着本装置的整个长度都显著地与血管壁接触。 [0114] In embodiments, apparatus 400 is further formed in a spiral shape and I2 of the apparatus of FIG. 13 in the embodiment shown, wherein the compliant body of the device to extend within the blood vessel, so that along the entire length of the apparatus are significantly in contact with the vessel wall. 在本例子中,装置的中心线也形成螺旋路径。 In the present example, the device also forms the centerline helical path. 此装置可以通过从管激光切割所需的支架模式409 或者通过切割扁平片材然后在热设定之前围绕着圆筒408包裹此扁平零件而形成。 This apparatus may be required by the stent pattern is cut from the tube 409 or by laser cutting flat sheet 408 is then wrapped around the cylindrical part of this flat form prior to heat setting. 因此,本装置具有与围绕着圆筒包裹宽丝带类似的形状。 Accordingly, the present apparatus has a wide ribbon wrapped around a cylindrical shape similar.

[0115]当沿着血管轴线看时,此装置不会显著地冲击到血管腔内。 [0115] When viewed along the vessel axis, this does not significantly impact the device into the blood vessel lumen. 通过将本装置定位在血栓和血管壁之间,血栓与血管壁接触的面积减小了,这使得血栓和血管之间的摩擦最小化并且减小了驱逐力。 By applying the present device is positioned between the vascular wall and the thrombus, the thrombus area in contact with the vessel wall is reduced, which makes the friction between the vessel and the thrombus is minimized and reduces expulsion force. 本装置还具有当血栓位于装置腔内侧时不压缩血栓的好处,这使血栓更容易驱出。 This device also has the benefit of thrombus when positioned inside the cavity without compression apparatus thrombosis, thrombosis which makes it easier to drive out. 典型的支架样取栓器(stentriever)装置接合血栓,使血栓主要被定位在该装置的外部径向表面上,同时血栓部分突伸到被切割模式的、位于支架之间的开放小室结构内。 Typical stent-like thrombectomy device (stentriever) means engaging the thrombus, thrombus positioned primarily on the radially outer surface of the device, while the thrombus is partially protrude into the cutting mode, the open cell structure located between the stent. 本发明的装置便于在血栓不被支架和冠状部压缩的情况下将整个血栓定位在装置的腔内。 In the apparatus of the present invention facilitates the case where the thrombus is not compressed stent and the entire thrombus crown portion positioned within the cavity means. 在用注射器或真空栗吸入的过程中,血栓接合在具有支架样取栓器的装置上能够禁止血栓由于血栓和装置支架之间的接合而流到吸入或中间导管内。 During Li syringe or vacuum suction of thrombus in the engagement means having a bracket-like device can be prohibited embolectomy thrombus and the thrombus due to the engagement between the holder flows to the suction device, or intermediate conduit. 本装置的本实施例便于吸入,因为血栓完全在装置的腔内并且各支架不阻挡血栓到吸入导管内的流动路径。 This device of the present embodiment facilitates the suction, because thrombus is completely endoluminal device in the supports and into the flow path without blocking the thrombus suction catheter.

[0116] 图14a示意出本发明的螺旋形装置的另一实施例425,其类似于图12和13示出的装置400。 Another [0116] Figure 14a schematically an apparatus according to the present invention, the spiral embodiment 425, which is similar to means 12 and 13 shown in FIG 400. 本装置包括细长的大致平面框架429,其可由丝或由相互连接的支架元件形成。 This apparatus comprises an elongated generally planar frame 429, which may be formed from wire or interconnected stent elements. 框架429被配置为涡旋形或螺旋形状并且在其近侧端428连接到细长轴杆427,在其远侧端430连接到碎片保护部分426,碎片保护部分426自身终止于远侧末端431中。 Frame 429 is configured as a volute or a spiral shape and is connected at its proximal end 428 to elongate shaft 427 at its distal protection portion 426 is connected to the end pieces 430, debris protection portion 426 itself terminates in a distal tip 431 in.

[0117] 图14b示出图14a的装置的侧视图,清楚地示意出碎片保护部分426,用于在血栓驱出和取出的过程中丢失栓塞物材料的危险最小化。 [0117] Figure 14b shows a side view of the device of FIG. 14a clearly illustrate debris protection portion 426, the risk of losing embolic materials used in the process and expelled thrombus removed minimized.

[0118] 螺旋形状的部件可被用作用于接合和除去血栓的外笼状件,或如图15中所示,如前述那样也可以用作外笼状件453内的内部件451,提供当在血栓内展开时使流动恢复的流动通道。 [0118] The shape of the helical member may be used for engaging and removing the thrombus outer cage member, or, as shown, as described above may be used as an internal member within the outer cage member 45,345,115 is provided when that the flow channels restored when expanded within the thrombus.

[0119] 图16中示出的附加实施例示出了扁平装置485,其已经被沿着装置的长度拧绕。 [0119] FIG. 16 illustrates an additional embodiment of the apparatus 485 is shown flat, which has been threaded along the length of the device around. 本装置包括支架482的框架。 This device comprises a stent framework 482. 在不受约束的构型中,本装置的中心线是直线并且本装置的两侧481被围绕着此轴线以双螺线形状拧绕,类似于拧绕的梯子或丝带。 In the unconstrained configuration, the center line of the apparatus and the rectilinear sides of the device 481 around this axis is to tighten around the double spiral shape, a ladder or similar twist around the ribbon. 如在这里描述的所有设计,本部件可被用于接合血栓以驱出和取出血栓,或者它可以是组件的一部分并且用作提供在展开时使流动立即恢复的流动通道的内部件。 All designs as described herein, the engaging means may be used to drive the thrombus and thrombus removed, or it may be provided as part of the assembly and the internal flow member immediately resume flow channel when deployed. 当用作流动通道时,本部件被定位在主要接合血栓的外笼状件内部。 When used as a flow channel, the member is positioned within the outer cage member engaging the main thrombus.

[0120] 图17a-e中示出的装置500具有本体部分501和远侧碎片保护部分502。 [0120] FIGS. 17a-e in the apparatus 500 shown in body portion 501 having a protection portion 502 and the distal fragment. 当沿着血管轴线看时,本体部分的截面面具有'S'形状,如在图17b-e中示出的。 When viewed along the vessel axis, the body portion having a sectional area 'S' shape, as shown in FIG. 17b-e in. 在不受约束的构型中, 'S'形状509的外臂是弯曲的,中间部分510形成直径。 In the unconstrained configuration, the outer arm 'S' shape 509 is curved, the diameter of the intermediate portion 510 is formed. 此装置的直径在长度上可变化,典型地在0.5mm直至10mm的范围内。 The diameter of the device may vary in length, typically in the range of 10mm up to 0.5mm. 本装置被设计为当在血栓515中展开时血栓与本装置外部部分上的小室结构模式相接合,并且还可以突伸到本装置的臂和直径部分之间的开口511内, 潜在地填充'S'形状的一侧。 This device is designed to, when deployed in a thrombus 515 cell structure pattern on the outer portion of the thrombus with the unit engagement, and also projects into the opening 511 between the arms and the diameter of the portion of the device, potentially filling 'S 'side of the shape. 'S'形状的另一侧提供受保护的流动腔512,用于在装置展开时恢复血流。 'S' shape is provided on the other side a protected flow chamber 512 for restoration of blood flow when the device is deployed. 'S'形状的两侧都是等效的并且任一侧可被展开为与血栓接触,如图17d和17e中所示的。 On both sides of 'S' shape on either side are equivalent and can be expanded into contact with the thrombus, 17d and 17e as shown in FIG. 本装置的哪一侧与血栓接触取决于展开的定向。 Which side of the apparatus in contact with the thrombus depends deployed orientation. 为了驱出血栓,在吸入作用下本装置被撤回到在近侧定位的气球状阻塞物引导管、标准引导管或鞘管鞘管内。 In order to drive the thrombus suction effect at the instrument is withdrawn proximally to the balloon-shaped stopper positioned guide tube, the guide tube or a standard sheath sheath. 可替代地,中间或远侧访问导管可被用于施加远侧吸入,并且本装置可被完全或部分地重新鞘装到导管内。 Alternatively, the intermediate or distal access catheter may be used to apply distally inhalation, and the present apparatus may be fully or partially re-loaded into the catheter sheath. 在重新鞘装过程中,突伸到'S'轮廓的一侧内的血栓可被'S'形状的臂夹紧和抓持,改进了本装置在血栓上的抓持。 In the re-installation process of the sheath, protrude into the 'S' contour of one side of thrombosis may be 'S' shaped gripping and clamping arm, improved grip on the device holding the thrombus. 血栓夹紧还可以通过将本装置部分地重新鞘装到微导管内而实现。 Thrombus clamping means may also be present in part by re-loaded into the sheath of the microcatheter achieved.

[0121] 'S'形状的臂509的边缘505可以是带有轮廓的或是弯曲的,用于改进血栓接合并且增加血栓突伸到被装置的一侧内。 [0121] 'S' shape of the edge 505 of arm 509 may be curved with a profile or for improving the engaging thrombus and thrombus increase in side protrude into the apparatus.

[0122] 图18a和18b示出本装置的其它实施例,其中流动通道601和'C'形状的外笼状件602被示出为直线构型(图18a)和螺旋形构型(图18b)。 [0122] Figures 18a and 18b show other embodiments of the apparatus, wherein the flow channels 601 and 'C' shaped outer cage member 602 is shown as a straight configuration (FIG. 18a) and a spiral-shaped configuration (FIG. 18b ). 这些图仅示出这两个部件的轮廓线, 而没有示出小室结构模式或支架的细节,其可以是在这里描述的和/或示意的那些中的任一个。 These figures show only the contours of these two components, and does not show details of the pattern or stent cell structure, which may be / at any one or described herein and those in a schematic.

[0123] 在图19a_c中示出的那种设计的可替代实施例中,装置610的扁平部分具有正弦形或类似波浪的边缘611,与管状的、'S'形的或'U'形的中心部分612结合,如在图1%和19c的截面图中示出的。 [0123] In that design shown in FIG. 19a_c alternative embodiment, the flat portion of the device 610 or the like, having a sinusoidal wave edge 611, and a tubular, 'S' shaped or 'U' shaped binding central portion 612, as shown in the sectional view of FIG. 1% and 19c in. 用于扁平部分的类似波浪边缘611可以提高装置的柔軔性,因为在脉管系统内其是围绕着弯曲的弯折部被展开或撤回。 Similar wave edge 611 may be used to improve the flexibility of the flat portion of the brake apparatus, since it is within the vasculature deployed or withdrawn bent around the bending portion. 'S'截面形状615具有在血栓中展开时始终提供用于恢复血流的、穿过本装置的流体腔的好处,而不管定向如何。 'S' has the benefit of cross-sectional shape 615 is always provided, through the present apparatus for recovering fluid chamber when deployed in the blood flow of the thrombus, regardless of what orientation. 不管装置的哪一侧被展开成与血栓接触,都存在受保护的通道允许血液流经本装置。 Regardless of which side of the device is deployed in contact with thrombosis, the presence of protected channels allowing blood flow through the present apparatus. 'S'形状增大了血栓和装置之间的血栓接触面积,提高了本装置与血栓接合以及驱出血栓的能力。 'S' shape increases the contact area between the thrombus and thrombus apparatus, the present apparatus improves the ability to drive and engages with the thrombus thrombus. 'S'截面形状还可以沿着装置的长度的涡旋形延伸,如在图20中示出的。 'S' may also extend along the sectional shape of a spiral wound length of the apparatus, as shown in FIG. 20. 在本装置被中间导管部分或完全重新鞘装的过程中,'S'形状还提供附加的血栓抓持,因为在'S'的臂内的血栓被夹在支架和中间导管末端之间。 In the process of the intermediate conduit portion or sheath completely re-installed in the present apparatus, 'S' shape also provide additional gripping thrombus, the thrombus as 'S' of the arm is interposed between the bracket and the intermediate end of the catheter.

[0124] 图21a-c示出装置的另一实施例650,其中中间部分651被形成为使得,当从垂直于血管轴线的侧面看时,图21b,它具有正弦或波形形状652。 [0124] FIGS. 21a-c illustrates a further embodiment of the apparatus 650, wherein the intermediate portion 651 is formed such that, when viewed from the side surface perpendicular to the axis of the blood vessel, FIG. 21b, which have a sinusoidal shape or wave 652. 本装置由两侧构成,如前面那样, 其中一侧面对着血栓或与血栓接触,而另一侧大致背离血栓。 This device consists of two sides, as before, wherein one side face in contact with thrombi or thrombus, thrombus generally away from the other side. 如果装置被颠倒,则先前面对着血栓的那一侧将背离血栓。 If the device is reversed, the previous side facing away from the thrombus thrombus.

[0125] 将装置形成为波浪形状使血栓和装置之间的接触压力沿着装置的长度变化,减小在各位置处本装置施加在血栓上的压缩。 [0125] The device is formed in a wave shape so that the contact pressure between the thrombus and the length variation means along, reducing the compression at the location of the unit at each applied on thrombosis. 本装置在被置于张力下时也可以是细长的,比如在血栓从脉管系统驱出的过程中。 This means that when placed under tension may be elongated, such as in the process of the thrombus from the vasculature in the drive. 这最小化了血栓的线性压缩并且在血栓的驱出过程中可使其细长,减小了血栓和血管壁之间的摩擦,并且因此减小了本装置除去血栓所需的驱出力。 This minimizes thrombus and thrombus linear compression process can be driven out of it an elongated, reduced friction between vessel wall and blood clots, and thus reducing the present driving apparatus for removing thrombus desired output.

[0126] 在图21c示出的本装置的另一实施例中,当沿着血管的轴线看时装置具有弯曲的边缘655。 [0126] In another embodiment of the apparatus of FIG. 21c illustrated embodiment, when viewed along the axis of the vessel has a curved edge apparatus 655. 这具有增大本装置与血管壁的接触面积、减小由本装置施加到壁上的接触压力的好处。 This means that with increased contact area with the vessel wall, reducing the benefits of applying the present device to the wall of the contact pressure. 当沿着血管轴线看时,弯曲的边缘655可与曲线657相切,曲线657相切到扁平部分656 或连续的曲线的一部分,使截面形状是被弄平的'S'。 When viewed along the vessel axis, a curved edge 655 may be tangent curves 657, 657 tangent to the curve part 656 or the flat part of a continuous curve, sectional shape is flattened 'S'. 此截面形状具有在折叠构型下改进了包裹轮廓的好处。 This cross-sectional shape having an improved profile wrapped in a folded configuration benefits. 这还有助于在局部或完全重新鞘装到中间导管、引导管、鞘管或微导管内的过程中本装置的弯曲部分夹住血栓。 This also contributes to partial or complete re-attached to the intermediate catheter sheath, the guide tube, sheath, or curved portions of the device within the microcatheter process sandwiched thrombus.

[0127] 图21d示出碎片保护锥形部653的视图,其由激光切割镍钛诺支架660形成并且还可以包括聚合物纤维,以增大碎片保护网状件的密度。 [0127] FIG. 21d shows a view of the tapered portion 653 of the protection fragment, which nitinol stent 660 is formed by the laser cutting and may also include polymeric fibers, to increase the density of the mesh member splinter protection. 此锥形部可通过激光切割扁平片材、 然后包裹成锥形形状而形成。 This tapered portion may be cut flat sheet by a laser, and then wrapped into a tapered shape is formed. 然后,片材可在接缝662处连接起来,例如通过激光焊接。 Then, the sheet may be attached together at a seam 662, for example by laser welding. 可替代地,接缝可被保持不连接,这样在手术过程中如果本装置需要重新使用的话有助于提高清洁的容易性。 Alternatively, the seam may be left unconnected, so that during the procedure if the present apparatus need to reuse it helps to improve the ease of cleaning. 射线透不过的线圈661或末端也可被添加到锥形部,用于增大荧光透视过程中的可视性。 Radiopaque coil 661, or may also be added to the end of the tapered portion, for increasing the visibility during fluoroscopy.

[0128] 中间部分651的一部分在图21e中示出了。 Part [0128] 651 in the intermediate portion 21e is shown in FIG. 本视图示出了浮动的或未连接的冠状部665和667,它们被形成为相对于中间部分的剩余部分出平面(out of plane)。 Crown portion 665 of the view shows a floating or unconnected and 667, which are formed with respect to the remaining portion of the intermediate portion out of the plane (out of plane). 在展开时这些冠状部接触血栓,提高本装置驱出血栓的能力。 When deployed in contact with the crown portion of thrombosis, improve the ability of the present device driven thrombus. 此外,当本装置围绕着弯折部撤回时,这些冠状部保持与血栓接触,提供了使血栓经过这些弯折部和分支部而取出的特殊好处。 Further, when the device is bent around the withdrawal portion, which is held in contact with the crown portion of the thrombus, thrombus provides special benefits through these bent portions and the branch taken.

[0129] 图22a_c示出了本发明的另一装置的血栓接合部分700的等轴测视图、平面图和侧视图。 [0129] FIG 22a_c shows an isometric view of the apparatus of the present invention further thrombus engaging portion 700, a plan view and a side view.

[0130] 装置700包括近侧支架706和707,它们可被连接到近侧细长构件(未示出)。 [0130] device 700 comprises a proximal stent 706 and 707, which may be connected to a proximal elongate member (not shown). 这些近侧支架被向远侧连接到支架元件网,手术支架元件网包括侧轨701和702,浮动小室结构705,和连接臂703。 These are connected to the proximal stent to the stent distally network element, the network element comprises a surgical stent 701 and side rails 702, 705 floating cell structure, and the connecting arm 703.

[0131]本发明的各装置、比如装置700可具有两个叠加的波形模式:具有相对短波长和幅值的第一模式叠加在具有相对长波长和幅值的第二模式上。 [0131] Each device of the invention, such as device 700 may have two superimposed waveform pattern: a first mode having a relatively short wavelength and amplitude superimposed on a second mode having a relatively long wavelength and amplitude. 本装置的支架元件被配置成施加相对强劲的恢复力到第一波形模式上,以使其从在微导管内的相对直线运输构型恢复到当其在血管中的血栓内展开时的波动起伏的或正弦的构型。 Support element of the device is configured to apply relatively strong restoring force onto a first waveform pattern to be restored from the opposite configuration of the linear transport within a microcatheter to the time when the fluctuating thrombus in a blood vessel to expand or sinusoidal configuration. 这允许本装置与血栓接合并且温和、但很牢固地抓持血栓以开始驱出。 This allows the present apparatus thrombus engagement and moderate, but very strong grip to start driving the thrombus. 为了取出血栓,在本装置和血栓被安全撤回到大接收导管之前,可能必须使本装置和血栓向近侧撤回到更大血管直径。 In order to remove the thrombus, and the thrombus in the present apparatus to secure large before receiving the catheter withdrawn, so that this apparatus may be withdrawn proximally to the thrombus and the larger diameter of the vessel. 第二波形模式帮助在此撤回过程中保持控制被捕捉的血栓。 In this second waveform model to help control withdrawal process remains captured thrombus. 随着血管尺寸的增大,此大幅值的模式使本装置有效地变化尺寸至该血管,并且使本装置在更大、更近侧的血管直径中能够保持与血栓接触, 否则在该血管内血栓可能从本装置驱离。 With the increase of the size of the vessel, this large amplitude pattern of the present apparatus to effectively vary the size of the vessel, and the larger the unit, the more proximal diameter of the vessel can be maintained in contact with the thrombus, or blood vessel within the this thrombus may be dislodged from the apparatus.

[0132]在图22c的侧视图中能够最清楚地看到两个不同的波形模式,其中整个血栓接合部分的实际中心线遵循幅值较大的曲线723,并且本装置的两个侧轨701和702分别遵循节距(pitch)较短的正弦模式721和722。 [0132] can be seen most clearly in two different waveform pattern 22c in a side view, wherein the entire thrombus engagement portion to follow the center line of the actual larger amplitude curve 723, and two side rails 701 of the apparatus and 702, respectively, follow pitch (pitch) shorter sinusoidal pattern 721 and 722.

[0133]图23a示出与血管段756中的血栓757接合的装置750的示意图。 [0133] FIG. 23a shows a schematic of an apparatus 750 and the vessel segment 756 of thrombus 757 engaged. 装置750类似于装置700,但具有附加碎片保护部分751,该附加碎片保护部分751具有添加到其远侧端的远侧末端752。 Device 750 is similar to device 700, but has an additional splinter protection portion 751, the additional splinter protection portion 751 having added thereto a distal end 752 of the distal tip. 装置750包括本体部分754,其在近侧端753可连接到细长轴杆(未示出)。 Device 750 includes a body portion 754, which may be connected to an elongate shaft (not shown) at the proximal end 753. 本体部分754被配置为在展开时扩张成波动起伏的波形、类似正弦的波形模式,如图23a所示的。 The body portion 754 is configured to be expanded upon deployment fluctuating waveform similar to a sine waveform pattern, as shown in FIG 23a. 此波形模式包括峰部761,峰部761致使血栓在与所述峰部相邻的离散区域中局部收缩,比如图示的区域760,但使在血栓本体的大部分上的总压缩最小。 This waveform pattern comprising peaks 761, local peaks 761 causes thrombus contraction in a portion adjacent to said peak with discrete areas, such as illustrated in region 760, but minimize the total compression on most thrombosis body. 因此,在展开时,由于本装置的作用,血栓的总体特性相对不变,但离散的区域760被本装置压缩和抓持。 Thus, when deployed, due to the action of the device, thrombus overall characteristics relatively unchanged, but the discrete regions 760 are compressed and grip the present apparatus. 此压缩导致血栓一定程度上局部脱水,增大了其摩擦系数,因此增大了其与本装置的抓持和接合。 This compression causes local dehydration thrombus to a certain extent, increasing its coefficient of friction, and thus increasing the gripping engagement with the device. 但是,因为血栓的大部分维持不被本装置压缩,所以血栓与血管的摩擦接合不会显著增大。 However, because most of the thrombus is not compressed to maintain the present apparatus, the friction engagement and vascular thrombosis without significantly increasing.

[0134]图23b示出当被收缩到更大直径、更近侧的血管段758内时的图23a的系统。 [0134] As shown in FIG. 23b is contracted to a larger diameter, in view of the system more proximal segment 758 23a of the vessel. 在此更大直径的血管中,本体部分754采用总体上通过中心线759描述的第二波形模式。 In this larger diameter vessel, the body portion 754 using a second wave pattern is generally described by the center line 759. 这可以通过将本装置配置成在其自由扩张状态下采用图23b示出的形状而实现,这可以通过将镍钛诺装置热设定成此形状而实现,例如。 This can be achieved by the present apparatus configured to employ a shape shown in FIG. 23b at its free expanded state, which can be heat set nitinol means to achieve this shape, for example. 因此,本装置当在微导管内进行折叠以备运输时具有一定存储能量。 Accordingly, the present apparatus has a certain energy storage when folded for shipment within the microcatheter. 在血栓内展开时,此能量的相当大一部分被释放,以使本装置呈现图23a的短波长模式。 When deployed within the thrombus, a significant portion of this energy is released, so that this device presents a short wavelength pattern 23a of FIG. 当本装置撤回到更大直径的血管内时,剩余的存储能量被施加,以使本装置能够呈现图23b示出的、被叠加的长波长模式,通过增大本装置的有效直径并且保持与血栓和血管壁的同位关系,帮助本装置保持在被捕捉的血栓上的抓持。 When the apparatus of the present endovascular withdrawn to a larger diameter, the remaining stored energy is applied, so that this apparatus capable of presenting shown in FIG. 23b, the superimposed long-wavelength mode, by increasing the effective diameter of the device and maintaining relationship with the position of the vessel wall thrombosis and helps the holding means on the captured thrombus grip.

[0135] 本装置的本实施例和其它实施例可具有另外的波形模式特征,比如在图22b的平面图中的侧轨701和702的曲率,以及“出平面”突伸特征,比如在图21b和21c中更清楚示出的浮动冠状部705。 Examples and other embodiments [0135] according to the present apparatus embodiment may have additional waveform pattern features, such as side rails 701 in the plan view of FIG. 22b in and curvature 702, and protruding features "out of plane", as in FIG. 21b and 21c is more clearly illustrated in the floating crown portion 705.

[0136] 图24a中示出的装置800是本发明的另一实施例。 In [0136] Figure 24a shows a device 800 is another embodiment of the present invention. 本装置包括中间部分801,在一个实施例中中间部分801由扁平片材形成并且设定成具有扁平或带轮廓截面的一系列波形形状。 This apparatus includes an intermediate portion 801, in one embodiment, the intermediate portion 801 is formed from a flat sheet and the corrugated shape is set to have a series of flat or contoured cross section. 此截面也可以通过弄平切割管或当沿着血管轴线看时使用卵形或椭圆形横截面形状的管而形成。 This flattened cross-section can also be formed using cut tube or oval or elliptical cross-sectional shape when viewed along the vessel tube axis. 在图示的实施例中,中间部分801被与碎片保护特征802和近侧部分803相结合。 In the illustrated embodiment, the intermediate portion 801 is combined with a splinter protection feature 802 and a proximal portion 803. 近侧部分可以是单独的部件并且被形成为管状或锥形形状。 The proximal portion may be a separate member and is formed into a tubular or conical shape. 本部分通过一个或多个近侧支架804而连接到本装置,该一个或多个近侧支架804连接到被定位于装置轴杆806上的领部805。 This section is connected to the unit via one or more proximal stent 804, the one or more proximal stent 804 is positioned on the connecting means to the shaft portion 806 of the collar 805.

[0137] 领部805可被固定到轴杆806或者它可以自由移动并且能够沿着轴杆滑动。 [0137] Collar portion 805 may be secured to the shaft 806 or it may move freely and can slide along the shaft. 图24b 示出本装置的平面图,其中近侧部分803处于相对于中间部分801的近侧位置。 Figure 24b shows a plan view of the apparatus, wherein the proximal portion 803 is in a proximal position with respect to the intermediate portion 801. 这是本装置在血栓或阻塞物中初始展开时的典型定向。 This is a typical orientation during initial deployment of the present device or thrombotic blockage of. 当装置800被撤回以驱出血栓时,由于部件和血管壁之间有摩擦所以近侧部分803初始保持静止。 When the apparatus 800 is withdrawn to drive thrombus, since between the friction member and the vessel wall so that the proximal portion 803 initially remains stationary. 在本装置撤回时,中间部分801和血栓相对于部分803向近侧移动,允许血栓在近侧部分的支架的作用下部分地回撤。 At the time of the withdrawal device, the intermediate portion 801 and portion 803 with respect to the thrombus moves proximally, allowing the thrombus retracement partially under the effect of the proximal portion of the stent. 这帮助在本装置被撤回到更大直径血管内时抓持血栓以及防止损失与血栓的接触。 This helps catch is withdrawn to the larger diameter of the vessel holding the thrombus and thrombus prevent loss of contact with the unit. 本装置继续撤回导致所有部分作为单一单元向近侧收缩,因为近侧部分803的移动受到与中间部分801的近侧连接部接触的、轴杆806上的领部805限制。 This results in all parts of the device continues to shrink withdrawn proximally as a single unit, since the movement of the proximal portion 803 being in contact with the intermediate portion 801 of the proximal connector, the collar portion 805 on shaft 806 limits. 然后,本装置和血栓可被撤回到近侧导管,用于从脉管系统除去。 Then, the present apparatus and thrombi can be withdrawn proximally into the catheter for removal from the vasculature.

[0138] 图25a示出本发明的另一实施例的等轴测视图。 [0138] Figure 25a illustrates another embodiment of the present invention is an isometric view of the embodiment. 在本装置85〇中,类似于在图22中描述的,本体部分851被形成有纵向波形形状。 In the present apparatus in 85〇, similar to that described in FIG. 22, the body portion 851 is formed with a longitudinal wave shape. 本体部分851还在一个或多个连接点855处被连接到两个或更多个拉丝853和854。 The body portion 851 also a plurality of connection or point 855 is connected to two or more drawing 853 and 854. 这些拉丝853,854延伸至近侧手柄(未示出),在手柄处使用者或医生能够对丝施加拉力。 The drawing 853, 854 extends to a proximal handle (not shown), it is possible to tension filament for a doctor or a user at the handle. 通过将这些丝置于拉力下,可以改变本体部分851的波形轮廓并且可以缩短峰部859和860之间的节距距离。 By filaments placed under tension, the waveform profile can be changed and the body portion 851 can be shortened pitch distance between peaks 859 and 860. 这可以导致血栓在波形形状的谷部856 部分处的夹紧增大。 This may lead to thrombosis increases the clamping portion 856 at the valley portions of the wave shape. 图25b示出装置850在血管(未示出)中展开并且与血栓857接合。 Figure 25b illustrates a device 850 deployed in a vessel (not shown) and 857 engage with the thrombus. 通过制动穿过微导管858的拉丝853,血栓857被抓持和压缩在本装置的谷部部分S5e中。 Drawing the brake through the microcatheter 853 858, and thrombus 857 is gripped and compressed in the valley portion of the present apparatus S5e.

[0139] 图25c示出本装置的另一反复方式(iteration)沿着血管轴线的侧视图。 [0139] FIG. 25c shows another embodiment of the present device repeatedly (Iteration) side along the vessel axis. 在本设计中,通过使用者向拉丝861和862施加拉力导致'S'形状的侧翼863和8G4朝向'S'的直径部分865移动。 In this design, the drawing by a user pulling force leads 861 and 862 and side flaps 863 8G4 'S' shape towards the diameter of the 'S' portion 865 moves. 当本装置被展开为与血栓(未示出)接触时,侧翼863和864的致动夹住血栓,提高本装置在血栓上的抓持。 When the present apparatus is deployed with the thrombus (not shown) in contact, flank 863 and 864 sandwiched actuation thrombosis, improve the gripping means present on the thrombus. 可替代地,通过拉丝862和861使用者可以提高本装置完全扩张和在更大面积上接合血栓的能力。 Alternatively, the present device can improve the ability to fully expand and engage the thrombus over a larger area by drawing 862 and 861 users.

[0140] 图26a-26d示出本发明的装置的使用方法。 [0140] FIGS. 26a-26d illustrate a method of using the apparatus of the present invention. 引导丝904和微导管9〇2被插入脉官系统900中,并且使用常规己知的技术被推进跨过阻塞性血栓901。 And the guide wire 904 is inserted into the microcatheter 9〇2 officer pulse system 900, and a conventional known technique is advanced across 901 obstructive thrombus. 当微导管902被定位在阻塞性血栓901的远侧时,从脉管系统900除去引导丝904,以允许取血栓装置910被推进穿过微导管902。 When the microcatheter 902 is positioned at the distal obstructive thrombus 901, 900 is removed from the vasculature of the guide wire 904 to allow the device 910 to take thrombus is advanced through the microcatheter 902. 装置910被以折叠的构型推进直到本装置的远侧末端到达微导管902的远侧端。 Device 910 is advanced until the distal tip of the device reaches the distal end of the microcatheter 902 in a folded configuration. 微导管902被撤回,同时装置910的位置被维持以横跨血栓901而展开取血栓装置,使得装置910的远侧端优选被定位在血栓901远侧。 The microcatheter 902 is withdrawn, while the device 910 is maintained in position across the thrombosis 901 is deployed to take thrombus means 910 such that a distal end of the device is preferably positioned in the distal thrombus 901. 本装置910包括被连接到细长的近侧轴杆部分911 的血栓接合部分912。 This device 910 comprises a proximal shaft coupled to the elongated rod portion 911 of the engaging portion 912 of thrombus. 装置910扩张,以使其以波形模式与阻塞性血栓接合,这导致血栓在与本装置的峰部相邻的离散区域中局部压缩,但使在血栓本体的大部分上的总压缩最小。 Expansion device 910, the waveform pattern so as to engage obstructive thrombus, which leads to thrombosis locally compressed at the peak portion of the apparatus adjacent to the discrete areas, but minimize the total compression on most thrombosis body. 根据需要,可允许装置910在血栓901内潜伏一段时间。 If necessary, the device 910 may allow latency period 901 within the thrombus. 按照标准技术,通过使引导管上的气球状体915膨胀,可以利用血管中的流动抑制。 According to standard techniques, the balloon-shaped member on the guide tube 915 expands, the flow can be suppressed by using the blood vessel. 收缩装置910将血栓从其在动脉中的位置驱出, 进一步撤回本装置会取出血栓901,直到其被取回到引导管903或引导鞘管内。 Thrombus contraction means 910 driven out from its position in the artery, further withdrawal of the device will remove the thrombus 901, until it is taken back into the guide tube 903 or guide sheath. 图26d示意出在取出到引导管903内的过程中与本装置接合的血栓。 FIG. 26d illustrate engaged with the present apparatus during the removal to the guide tube 903 in the thrombus. 血流阻断、吸入和其它标准技术可在取血栓过程中使用。 Vascular occlusion, inhalation and other standard techniques may be used in the process of taking the thrombus. 装置910可用盐溶液冲洗并且在重新装载到插入工具内之前进行温和清洁。 Available rinsing device 910 and the salt solution gentle cleaning before re-loaded into the insertion tool. 装置910可被重新引入到微导管内以在阻塞性血栓的其它部段中再展开,如果需要的话。 Device 910 may be re-introduced into the microcatheter to expand in the other sections of obstructive thrombus, if desired.

[0141] 图27a-27d示出了图26a-26d中示出的装置的细节并且示意出图23中示出的装置的一个实施例。 [0141] FIGS. 27a-27d illustrate details of the apparatus of FIGS. 26a-26d in the illustrated embodiment and is a schematic illustrating an embodiment of apparatus 23 shown in FIG. 图27a示出了包含血栓接合部分930和近侧轴杆931的装置的侧视图。 Figure 27a shows a side view and a device comprising a proximal portion 930 of the shaft 931 engaging the thrombus. 图27b 示出装置的平面图,而图27d示出同一装置的等轴测视图。 Figure 27b shows a plan view of the apparatus, and FIG. 27d shows an isometric view of the same apparatus, and the like. 图27c示出图27a中详细示出的截面图AA。 Figure 27c illustrates a sectional view AA shown in detail in 27a shown in FIG. 本装置可以由扁平片材形成并且被热设定成一系列波形形状,但保持扁平截面。 This means may be formed from a flat sheet and thermally set to form a series of waveforms, but remains flat cross section. 在另一实施例中,本装置可以具有弯曲的或带轮廓的截面,或者通过弄平切割管或使用当沿着血管轴线看时为卵形或椭圆形截面形状的管形成。 In another embodiment, the present device may have a curved or contoured cross-section, or by cutting the tube or flattened tube is formed using an oval or elliptical cross-sectional shape when viewed along the vessel axis. 如在这里示出的所有实施例一样, 本装置可以引入碎片保护特征,例如,比如在图23a和23b中示出的那些。 As all of the embodiments as illustrated herein, the present device may be incorporated debris protection features, e.g., such as shown in those FIGS. 23a and 23b.

[0142] 在一个实施例中,在自由扩张状态下波形模式的幅值是将要取出的阻塞性血栓所处的血管的直径的0.5和3.0倍之间。 [0142] In one embodiment, 0.5 and 3.0 times the diameter of the vessel in a free expanded state is the amplitude of the waveform pattern to be extracted is located between obstructive thrombus. 在优选的实施例中,在自由扩张状态下波形模式的幅值是将要取出的阻塞性血栓所处的血管的直径的0.5和2.0倍之间。 In a preferred embodiment, 0.5 and 2.0 times the diameter of the vessel in a free expanded state is the amplitude of the waveform pattern to be extracted is located between obstructive thrombus. 在最优选的实施例中, 在自由扩张状态下波形模式的幅值是将要取出的阻塞性血栓所处的血管的直径的〇. 5和1.5倍之间。 In a most preferred embodiment, the diameter of the vessel in a free expanded state is the amplitude of the waveform pattern to be taken out of obstructive thrombus in which the square. Between 5 and 1.5. 在自由扩张状态下波形模式的节距优选在将要取出的阻塞性血栓所处的血管的直径的1.0和4.0倍之间。 1.0 and 4.0 times of the waveform pattern pitch free expanded state is preferably located in obstructive thrombus to be taken out of the vessel diameter between. 在自由扩张状态下波形模式的节距优选在波形模式的幅值的0.5和2.0倍之间。 In the waveform pattern pitch of the free expanded state is preferably between 0.5 and 2.0 times the amplitude of the waveform pattern. 在人大脑中动脉内使用的优选实施例中,波形模式的幅值在2.0mm和6.0mm之间而波形模式的节距在3.0mm和8.0mm之间。 Used in the preferred embodiments the NPC cerebral artery embodiment, the pitch between the amplitude of a waveform pattern between 2.0mm and 6.0mm and 3.0mm and the waveform pattern of 8.0mm.

[0143] 装置的另一实施例在图28a-28c中示出了。 Another [0143] embodiment of the apparatus in FIGS. 28a-28c illustrate. 图28a中示出了装置的等轴测视图,图28b示出侧视图,而图28c示出同一装置的平面图。 FIG 28a shows an isometric view of the apparatus, Figure 28b shows a side view, and FIG 28c illustrates a plan view of the same apparatus. 装置952包括被连接到细长轴杆951的血栓接合部分950。 Apparatus 952 includes elongated shaft 951 connected to the engaging portion 950 of thrombus. 部分950可通过如下形成:将扁平片材激光切割成小室结构模式并且热设定成部分或整个的波形模式,以与血栓接合而提供良好的驱出抓持,但总血栓压缩最小。 Portion 950 may be formed by: laser cutting a flat sheet mode and the cell structure to heat set portion or the entire waveform pattern, to engage the thrombus and to provide a good gripping driven out, but the overall minimum compression thrombosis. 这种装置可包括在这里其他地方公开的小室结构模式中任一者,并且可被用于如关于图26a-d描述的那样取回血栓。 Such means may include a cell structure pattern elsewhere herein disclosed in any one, and can be used as thrombus retrieval respect to FIG 26a-d described herein. 本装置的波形形状沿着装置的长度改变血栓和装置之间的接触压力,形成峰部953和槽部954,在峰部953处本装置在血栓上施加相对高的压缩力,在槽部954 处本装置在血栓上施加很小或不施加压缩力。 Waveform shape of the device varies along the length of the contact pressure between the apparatus and the apparatus thrombus, forming peaks 953 and grooves 954, applying a relatively high compressive force on the thrombus present in the device 953 at the peak portion, the groove portion 954 at this means exerts little or no thrombus in the compressive force is applied. 峰部953之间的槽部954用作接收空间,血栓当在峰值953处压缩时可以自由流动到该空间内。 The groove portions between the peaks as a receiving space portions 953,954, when the peak of the thrombus compression 953 can flow freely into the space. 较高压缩的区域允许本装置的支架嵌入血栓内,形成用显微镜可看见(支架)和肉眼可见(本装置的波形模式)两种水平的机械夹紧。 Higher compression region of the device allows the stent embedded in the thrombus formed visible with a microscope (brackets) and macroscopic (waveform pattern of the present apparatus) two levels of mechanical clamping. 本装置当被置于张力下时,比如在血栓从脉管系统驱出的过程中,也可以是细长的。 When the present apparatus is placed under tension, as in the process of thrombus expelled from the vasculature, and may be elongated. 这使血栓的线性压缩最小化并且在驱出过程中可使血栓细长,减小血栓和血管壁之间的摩擦,以及因此减小本装置除去血栓所需要的驱出力。 This compression of the linear minimize thrombus and the thrombus can drive the process in the elongated, reduced friction between vessel wall and blood clots, thrombosis, and thus reduce the need for removing the unit drive output.

[0144]图29a示出不同扁平装置模式的例子,其可被形成为纵向的或侧向的波形形状。 Examples [0144] Figure 29a shows a flat means different modes, which may be formed in a waveform shape of the longitudinal or lateral. 切割模式可被优化,以使特定的小室结构特征、比如冠状部或横支架与波形模式的峰部和槽部对齐,以最大化血栓嵌入和抓持。 Cutting mode may be optimized for a particular structural features of the cell, such as a crown or a cross bracket and the waveform model peaks and troughs are aligned to maximize grip and embed thrombus. 例如,一行小室结构973可被与波长对齐,使得冠状部974被定位于本装置波形的峰部和槽部(最大或最小波形幅值)处。 For example, the cell line structure 973 may be aligned with the wavelength, so that the crown portion 974 is positioned on the unit waveform peaks and troughs (maximum or minimum waveform amplitude) at. 类似地,横支架975可被定位于波形的峰部和槽部处,或在具有中间波形高度的中心线处。 Similarly, cross beam 975 may be positioned in the groove portion and the peak portion of the waveform, or a waveform having a centerline at an intermediate height. 装置971的外边缘可以是弯曲的,以最小化血管接触压力。 An outer edge device 971 can be curved to minimize the contact pressure vessel.

[0145]图29a中示出的装置当沿着血管轴线看时可具有扁平的、弯曲的或带轮廓的横截面,例如图2%示出本实施例的截面图(BB)。 In [0145] Figure 29a shows the apparatus when viewed along the vessel axis may have a flat, curved or contoured cross-section, such as shown in FIG. 2% of a cross-sectional view of one embodiment of the present (BB). 此截面图示意出弯曲轮廓,在形成过程之前或作为该形成过程的一部分该弯曲轮廓可被热设定成本装置,用于生成波形。 This cross-sectional view schematically illustrating a curved profile forming process before or as part of the process the curved profile is formed can be heat set cost means for generating a waveform. 本装置的横截面形状可以是扁平部分和弯曲部分的组合,如图2%中所示,其中本装置在中间部分980中是扁平的,与每一侧981处弯曲部分以及附加直线部分982相接合。 Cross-sectional shape of the apparatus may be a combination of flat and curved parts, as shown in FIG. 2%, which means in this intermediate portion 980 is flat, and each side of the bent portion 981 and an additional straight portion 982 with engagement.

[0146]图30a_3〇f示出本发明的另一装置1〇〇6的使用方法,其中,类似于图12示出的那样,本装置在自由扩张的状态下呈现大致涡旋形或螺旋形的构型。 [0146] FIG 30a_3〇f illustrates another method of using the apparatus of the invention 1〇〇6, wherein, similarly as shown in FIG. 12, this device presents a generally helical or spiral wound in a free expanded state configuration. 此装置可以通过从管激光切割成所需的支架或通过切割扁平片材、然后在热设定之前围绕着芯轴包裹此扁平零件而形成。 This apparatus may be cut by a flat sheet cut to the desired stent or by laser from a tube, the mandrel is then formed around the flat part of this package prior to heat setting. 图30a-30f示出本发明的装置的使用方法。 FIGS. 30a-30f illustrates a method of using the apparatus of the present invention. 图3〇a示出动脉1〇〇1的代表,其具有分支和定位在分支处的阻塞性血栓1002。 FIG 3〇a shows the representative 1〇〇1 arteries having branches and is positioned at the branch 1002 of obstructive thrombus. 微导管1003被插入动脉1001内并且被使用常规已知的技术推进而横跨过阻塞性血栓10〇2。 The microcatheter 1003 is inserted and through and across the obstructive thrombus 10〇2 using conventional techniques known in advance intraarterial 1001. 然后,取血栓装置1006可被推进穿过微导管1003到达目标部位。 Then, taking the thrombus 1006 may be advanced through the microcatheter 1003 to the target site. 微导管被收缩,同时保持装置10〇6的位置以横跨血栓展开取血栓装置,以使装置1011的碎片保护部分优选被定位于血栓1002的远侧。 Splinter protection microcatheter portion is contracted, while maintaining the position of the apparatus 10〇6 to expand across the thrombus take thrombus means so that the device 1011 is preferably positioned distal to the thrombus 1002.

[0147]装置10〇6包括被连接到细长近侧轴杆部分和远侧碎片保护部分1011的血栓接合部分1010。 [0147] 10〇6 comprises means coupled to the elongate shaft proximal portion and a distal portion 1011 of the thrombus debris protection engagement portion 1010. 装置的血栓接合部分1010扩张成螺旋形构型,允许血栓部分地或完全地被该装置包封。 1010 expansion portion helically configuration, allowing thrombus partially or completely encapsulated the thrombus device engagement means. 这允许本装置抓持和驱出血栓,同时使在血栓本体上的总压缩最小,使血栓更容易除去。 This allows the present apparatus and gripping drive thrombus, while the overall compression in the smallest body thrombus, thrombus easier to remove. 初始驱出时,血栓可能部分地位于本装置的外面或近侧,并且在撤回到引导管或鞘管的过程中可以朝向装置的中心移动。 When the initial driving, the thrombus may be located outside or proximal part of the device, and can be moved toward the center of the device during withdrawal of the guide tube or sheath tube. 引导管1005和中间导管1004在图30b-30f中示出了。 Intermediate conduit 1005 and the guide pipe 1004 in FIG. 30b-30f are shown. 在图30d中示出的使用方法中,中间导管1〇〇4被向前移动至血栓1〇〇2的表面,并且在将本装置和血栓取出到引导管1005内之前施加局部吸气。 In FIG. 30d using the method shown, the intermediate catheter is moved forward to the surface 1〇〇4 1〇〇2 thrombus, and the thrombus in the present extraction apparatus and the guide tube 1005 before the suction is applied locally. 本装置还可以与血流阻断,吸气和在取血栓过程中通常使用的其它标准技术一起使用。 The device can also block blood flow, and suction used with other standard technique in the process of thrombus taken generally used. 图30e-30f示意出,在驱出和取出到引导管或鞘管1〇〇5内的过程中,装置1011的碎片保护部分如何能够捕捉可能会脱离或释放出的阻塞性血栓1002的碎片1012。 FIG. 30e-30f illustrate, in the driving process and withdrawn into the guide tube within the sheath 1〇〇5 or debris how the protective portion 1011 may be capable of capturing or released from the thrombus debris obstructive 1002 1012 .

[0148]图31示出本装置的另一实施例1〇3〇,其中装置的近侧部分被以大致涡旋形或螺旋形形状1〇31 (类似于图3〇的装置10〇6)配置并且被连接到径向或管状部分1033。 [0148] FIG. 31 shows a further embodiment according to the present embodiment 1〇3〇 apparatus, wherein the proximal portion of the device is substantially the shape of a scroll or spiral 1〇31 (similar to the apparatus 10〇6 3〇) configuration and is connected to tubular portion 1033 or radially. 螺旋部分可被连接到近侧轴杆1〇34或本装置的其它部分。 Helical portion may be connected to another portion of the proximal shaft 1〇34 or the device. 远侧管状部分包含碎片保护部分1035并且被连接到远侧用来防止损伤的、射线不能透过的末端1032。 The tubular portion includes a distal portion 1035 and splinter protection is connected to prevent damage to the distal end of the radiopaque 1032. 图示的螺旋部分1031是示意性表示并且典型地包括激光切割小室结构模式。 Helical portion 1031 is illustrated a schematic representation and typically comprises laser cutting a small cell structure mode. 装置的螺旋部分1031用于提供用于驱出富含纤维的粘性血栓的改进了的性能,同时在撤回到引导管或鞘管的过程中管状部分1030提供良好的血栓保持。 Screw part 1031 for providing a means of driving the fiber-rich thrombi improved viscosity properties, while during the withdrawal of the guide tube or sheath of the tubular portion 1030 to provide a good holding thrombus. 如这里示出的所有实施例,在重新装载到插入工具内之前,本装置可被进行冲洗和温和的清洁。 As all of the embodiments shown here, before re-loaded into the insertion tool, the apparatus may be mild cleansing and rinsing. 如果需要的话,本装置可被重新引入微导管内,在阻塞性血栓的其它段中重新展开。 If desired, the apparatus may be re-introduced into the microcatheter, re-expanded in the other segments of obstructive thrombus.

[0149]图32a示出本发明的另一取血栓装置的等轴测视图,包括在近侧附接到细长轴杆1051并且在远侧附接到可选的远侧末端1055的血栓接合部分1050。 [0149] FIG. 32a shows another apparatus according to the present invention, taken thrombus isometric view, to an elongated shaft comprising a proximal 1051 and is attached to the distal tip of the distal optionally attached engagement thrombus 1055 part of 1050. 血栓接合部分1050包括由小室结构元件1052形成的一对侧轨,多个血栓接合支架元件1053和1054被连接到这些小室结构元件1052。 Thrombus engagement portion 1050 includes a pair of rail member 1052 by the cell structure formed of a plurality of elements 1053 and stent thrombosis engagement cell structure of these elements are connected to 10,521,054. 支架元件1053和1054从由侧轨限定的平面的相反两侧突伸,如图32b的侧视图示出的。 1053 and 1054 projecting support element projecting from opposite sides of a plane defined by the side rails, the side view of FIG. 32b illustrated. 此设计意于以与前述的波状装置类似的原理操作,用于在横支架1053和1054 处提供嵌入到血栓内的高嵌入力的局部区域,相邻的区域具有很小或没有嵌入或径向力。 This design is intended to the wave-like device with the similar operation principle, for providing a high insertion force embedded within the thrombus local region cross beam 1053 and 1054, adjacent a region having little or no radial or embedded force. 在横支架处的高嵌入力在血栓和装置之间形成机械干涉,使本装置能够牢固地抓持血栓, 但是,因为这种嵌入以及形成的对血栓的压缩应用于非常离散且有限的区域上,所以对血栓总体的性能影响最小。 In areas of high insertion force on the cross beam at the thrombus formed between the apparatus and the mechanical interference, so that the apparatus can securely grip the thrombus, however, since such embedding and compression of thrombus formation is applied to a discrete and limited so with minimal impact on the overall performance of the thrombus. 这是非常重要的优势,因为发明人已经发现对血栓的压缩可使血栓变得更坚硬并且可增大其摩擦系数,这两者可能使其更难取出。 This is a very important advantage, because the inventors have found that compression may cause thrombosis on thrombus becomes more rigid and may increase its coefficient of friction, it may be more difficult to remove both.

[0150]图33a示出本发明的另一取血栓装置的等轴测视图,其包括在近侧附接到细长轴杆1081并且在远侧附接到可选的远侧篮状部1082的血栓接合部分1080。 [0150] Figure 33a illustrates another apparatus of the present invention taken isometric view of a thrombus, which comprises an elongate shaft 1081 to attach the proximal and distal to the optional basket distal attachment portion 1082 thrombus engagement portion 1080. 血栓接合部分1080 包括多个相邻的段1083和1084,它们彼此近似直角地布置。 Thrombus engagement portion 1080 includes a plurality of adjacent segments 1083 and 1084, arranged approximately at right angles to each other. 每段1083或1084可具有大致扁平的形状,但形成的总体结构1080具有三维结构,如在图33b示出的侧视图中能够看到的。 Each segment 1083 or 1084 may have a generally flat shape, but the overall structure 1080 is formed having a three-dimensional structure, as shown in Figure 33b side can be seen. 这些交替的段在血栓中形成与前面示出的波状设计类似的高压缩区域和低压缩区域的类似模式,在血栓抓持和以最小力取出方面具有类似的优势。 These alternating segments form an undulating pattern similar to the design shown previously with similar high compression and low compression zone region of the thrombus, and the thrombus gripping with minimal power take advantage of a similar aspect.

[0151] 从前述的说明中很显然,虽然已经图示和描述了本发明的特殊实施例,但在不偏离本发明的实质和范围的情况下可以进行各种修改。 [0151] It is clear from the foregoing description, it has been illustrated and described particular embodiments of the present invention, but various modifications may be without departing from the spirit and scope of the present invention. 例如,虽然在这里描述的实施例参考了特殊特征,但本发明包括具有不同特征组合的实施例。 For example, although the embodiments described herein with reference to a particular feature, the present invention includes embodiments having different combinations of features. 本发明还包括不包含所有被描述的特殊特征的实施例。 The present invention also includes embodiments do not include all special features are described.

[0152] 因此,本发明不限制于前面描述的实施例,可以在结构和细节上进行改变。 [0152] Accordingly, the present invention is not limited to the foregoing embodiments described, may be varied in construction and detail.

Claims (36)

1. 一种用于从血管中除去阻塞性血栓的取血栓装置,其包括血栓接合元件,所述血栓接合元件具有收缩的运输构型和扩张的展开构型,所述血栓接合元件具有第一周围部分, 第二周围部分,和在第一周围部分和第二周围部分之间延伸的血栓接合部分,其中,在所述扩张构型中,这些周围部分被侧向地间隔开,所述血栓接合部分在这些周围部分之间延伸, 并且其中所述装置的至少一部分具有纵向延伸的波动起伏延伸的边缘。 An apparatus for taking thrombotic obstructive thrombus removed from the vessel, thrombosis including engaging element, expanded configuration and an expanded configuration of the transport element has a constriction engaging the thrombus, the thrombus engaging element having a first peripheral portion, a second peripheral portion, and thrombosis about the engagement portion between the first portion and the second peripheral portion extends, wherein, in the expanded configuration, the peripheral portions are laterally spaced apart, the thrombus the engagement portion extending between the peripheral portion, and wherein at least a portion of said means having a longitudinally extending edge fluctuating extending.
2. 根据权利要求1所述的取血栓装置,其中,所述波动起伏延伸的边缘具有类似波浪的形式。 2. Take thrombus apparatus according to claim 1, wherein the wavy edges having undulations extending wave-like form.
3. 根据权利要求1或2所述的取血栓装置,其中,所述波动起伏延伸的边缘具有正弦波的形式。 The thrombus taking device according to claim 12, wherein the fluctuating edge extending in the form of a sine wave.
4. 根据权利要求1至3中任一项所述的取血栓装置,其中,所述装置具有至少两个波动模式。 The apparatus 1 taking thrombus any 3-1 claim, wherein said device has at least two fluctuation mode.
5. 根据权利要求4所述的取血栓装置,其中,所述波动模式彼此叠加。 The thrombus taking apparatus according to claim 4, wherein the fluctuation mode superimposed on each other.
6.根据权利要求4或5所述的取血栓装置,其中,第一模式具有波长和幅值,第二模式具有比第一模式的波长和幅值大的波长和幅值。 6. Take thrombus claim 4 or claim 5, wherein the first mode has a wavelength and amplitude, the second mode and having a magnitude larger than the wavelength of the first wavelength and amplitude patterns.
7. 根据权利要求2至6中任一项所述的取血栓装置,包括用于改变波浪形状的激活器。 7. Take thrombus device according to any 2-6 claim comprising an activator for changing the shape of the wave.
8. 根据权利要求7所述的取血栓装置,其中,所述激活器包括至少一个推丝和/或至少一个拉丝。 8. To remove the thrombus apparatus according to claim 7, wherein said activator comprises at least one push wire and / or at least one drawing.
9. 根据权利要求1至8中任一项所述的取血栓装置,其中,所述血栓接合元件包括一个或多个血栓抓持特征。 9. The apparatus 1 taking thrombosis according to claim 8, wherein said engaging member comprises a thrombus or thrombi more gripping features.
10. 根据权利要求1至9中任一项所述的取血栓装置,其中,在所述收缩构型中血栓接合部分是大致扁平的。 10. The apparatus 1 taking thrombosis according to claim 9, wherein, in the contracted configuration thrombus engaging portion is substantially flat.
11. 根据权利要求10所述的取血栓装置,其中,在所述扩张构型中血栓接合部分是曲线形的。 Take thrombus device according to claim 10, wherein, in the expanded configuration thrombus engaging portion is curvilinear.
12. 根据权利要求10所述的取血栓装置,其中,在所述扩张构型中血栓接合部分是大致扁平的D Take thrombus apparatus according to claim 10, wherein, in the expanded configuration thrombus engagement portion is a substantially flat D
13. 根据权利要求1至9中任一项所述的取血栓装置,其中,在所述收缩构型和扩张构型两者中血栓接合部分是大致曲线形的。 13. The apparatus thrombus to take any one of claim 9, wherein, in both the collapsed configuration and an expanded configuration thrombus engaging portion substantially curvilinear.
14. 根据权利要求11至13中任一项所述的取血栓装置,其中,在所述扩张构型中血栓接合部分是螺旋的或涡旋的形式。 14. The apparatus thrombus 11 to take any one of claim 13, wherein, in the expanded configuration thrombus engaging portion is in the form of a spiral or scroll.
15. 根据权利要求11至13中任一项所述的取血栓装置,其中,在所述扩张构型中血栓接合部分是大致s-形的。 15. The apparatus thrombus 11 to take any one of claim 13, wherein, in the expanded configuration is substantially thrombus engaging portion s- shaped.
16. 根据权利要求1至15中任一项所述的取血栓装置,其中,所述血栓接合元件具有总体上面朝相反方向的两个表面,并且在所述扩张的展开构型中其中一个表面或两个表面能够与血栓接合。 16. The apparatus of thrombus take any one of 1 to 15 claim, wherein the engagement element has two surfaces thrombus above generally in opposite directions, and in the expanded deployed configuration wherein a surface or both surfaces engageable with the thrombus.
17. 根据权利要求1至16中任一项所述的取血栓装置,其中,所述装置包括当该装置处于扩张的展开构型中时限定出用于血液流动的流动通道的一部分。 17. The apparatus of thrombus take any one of 1 to 16 claim, wherein the apparatus comprises the apparatus when in an expanded deployed configuration time fix part of the flow path for the blood flow.
18. 根据权利要求1至9中任一项所述的取血栓装置,其中,所述装置包括近侧部分,远侧部分,和近侧部分和远侧部分之间的血栓接合部分,其中近侧部分相对于血栓接合部分可滑动地移动。 18. The apparatus thrombus to take any one of claim 9, wherein said means comprises a proximal portion, a distal portion, thrombosis between the proximal and distal portions and the engagement portion, wherein the near side portion of the thrombus with respect to the engagement portion slidably movable. I9•根据权利要求18所述的取血栓装置,其中,所述近侧部分包括领部和从领部伸出的近侧支架,所述血栓接合部分包括近侧轴杆,并且所述领部相对于近侧轴杆可滑动地移动。 I9 • means to take thrombosis according to claim 18, wherein said collar includes a proximal portion and a proximal portion extending from the bracket collar portion, said engaging portion comprises a proximal thrombus shaft and the collar portion relative to the proximal shaft slidably movable.
20. 根据权利要求19所述的取血栓装置,其中,所述近侧部分的支架中的至少一些支架在向远侧方向上延伸,用于在所述领部相对于近侧轴杆向近侧移动时将血栓至少部分地捕获在血栓接合部分和近侧支架之间。 20. The apparatus according to take thrombus claim 19, wherein the proximal portion of the stent in the stent extends over at least some of the distal direction, for the collar relative to the proximal portion to the proximal shaft thrombus at least partially captured between the engaging portion and the proximal stent thrombosis while side.
21. 根据权利要求2或3所述的取血栓装置,其中,所述波动模式具有从2.0mm至6.0mm的幅值。 21. The apparatus of thrombus take 2 or claim 3, wherein the fluctuation pattern having an amplitude of from 2.0mm to 6.0mm.
22. 根据权利要求2,3或21所述的取血栓装置,其中,所述波动模式具有从3.0mm至8.0mm的节距。 22. The apparatus of thrombus take 3 or claim 21, wherein the fluctuation pattern having a pitch of from 3.0mm to 8.0mm.
23. 根据权利要求2至22中任一项所述的取血栓装置,其中,所述血栓接合部分包括由支架和冠状部限定的多个小室结构,其中所述支架和/或冠状部中的至少一些被以类似波浪的形式布置,以增强血栓的嵌入。 23. The apparatus of thrombus take 2-1 according to any of claim 22, wherein said portion comprises a plurality of small chambers thrombus defined by the support structure and the crown engaging portion, wherein the bracket and / or the crown portion at least some of the waves are arranged in a similar form to enhance the embedded thrombosis.
24. 根据权利要求1至23中任一项所述的取血栓装置,其中,所述装置的血栓接合部分具有包含扁平部分和弯曲部分两者的横向截面。 24. The apparatus of thrombus take any one of 1 to 23 claim, wherein said means thrombus portion having a transverse cross-section comprising a flat portion and a curved portion both engage.
25.根据权利要求1至24中任一项所述的取血栓装置,其中,在所述扩张构型中,所述装置的血栓接合部分的至少一部分相对于纵向轴线呈大致涡旋或螺旋构型。 25. The apparatus thrombus to take any one of claim 24, wherein at least a portion of the expanded configuration, the engaging portion means thrombus longitudinal axis substantially vortexing or helical conformation type.
26.根据权利要求25所述的取血栓装置,其中,所述血栓接合部分还包括远侧管状部分。 26. The apparatus according to take thrombus claim 25, wherein said engagement portion further comprises a thrombus distal tubular portion.
27.根据权利要求26所述的取血栓装置,其中,在管状部分的远侧端处具有血栓碎片部分。 27. The apparatus of claim taking thrombus claim 26, wherein the thrombus debris having a distal end portion of the tubular portion.
28.根据权利要求1至9中任一项所述的取血栓装置,其中,所述血栓接合部分包括由小室结构元件形成的一对侧轨,多个血栓接合支架元件被连接到所述小室结构元件,所述小室结构元件从由侧轨限定的平面的相反两侧突伸。 28. 1-9 taken thrombus apparatus as claimed in any one of claims, wherein said engaging portion includes a pair of thrombus formed by the rail element cell structure, a plurality of stent thrombosis engagement element is connected to the chamber structural element, said structural member extends from the chamber opposite sides projecting plane defined by the side rails.
29. 根据权利要求1至9中任一项所述的取血栓装置,其中,所述血栓接合部分包括多个段,相邻的段彼此以约90°布置。 29. Take 1 to 9 thrombus apparatus according to any one of claims, wherein said plurality of engagement portions thrombus segments comprises adjacent segments arranged at approximately 90 ° to each other.
30. 根据权利要求29所述的取血栓装置,其中,所述段中的至少一些段具有扁平形状的横向截面。 30. The apparatus according to take thrombus claim 29, wherein at least some of said segments having a transverse section in the shape of a flat cross section.
31.根据权利要求1至30中任一项所述的取血栓装置,包括远侧的血栓碎片保护部分。 31. The apparatus according to take thrombosis of claims 1 to 30, any one of, the protective portion comprises a distal thrombus debris.
32. —种从血管除去阻塞性血栓的方法,包括步骤: 提供具有血栓接合部分的取血栓装置,所述血栓接合部分具有纵向延伸的波动起伏延伸的形式,所述装置具有收缩的运输构型和扩张的展开构型; 朝向阻塞性血栓并且跨过阻塞性血栓推进微导管; 将所述装置装载到微导管内并且将其所述装置进到微导管的远侧部分; 展开所述装置以使血栓嵌入;和将所述装置的至少一部分和被捕捉的血栓取出到取出导管内。 32. - ways, ranging from vascular obstructive thrombus removal, comprising the steps of: providing a means to take thrombus thrombus engaging portion, said engaging portion having thrombus form fluctuating extending longitudinally extending transport configuration, said apparatus having a shrinkage and an expanded deployed configuration; and across towards the obstructive thrombotic obstructive thrombus advancing a microcatheter; loading the device into the microcatheter and it proceeds to the distal portion of the apparatus of the microcatheter; said deployment means embedding thrombus; and at least a portion of the captured thrombus extraction means to remove the catheter.
33. 根据权利要求32所述的方法,包括在血栓内展开所述装置。 33. The method according to claim 32, comprising the deployment means thrombus.
34. 根据权利要求32或33所述的方法,包括在血栓和围绕着血栓的血管壁的那一部分之间展开所述装置的一部分。 34. The method of claim 32 or claim 33, comprising deployment of the device between a portion of that part of thrombus and thrombus around the vessel wall.
35.根据权利要求33或34所述的方法,包括在所述装置在血栓内展开之后向近侧拉动所述装置。 35. The method of claim 33 or claim 34, comprising a proximally pulling the device after the device is deployed within a thrombus.
36.根据权利要求35所述的方法,包括在展开所述装置后延迟向近侧拉动所述装置,以在向近侧拉动所述装置和血栓之前进一步将所述装置嵌入到血栓内。 36. The method according to claim 35, comprising after deployment of the device is pulled proximally said delay means to said further means before the device is pulled proximally embedded within the thrombus and thrombus.
37.根据权利要求35或36所述的方法,包括在将所述装置取出到取出导管之前将所述装置向近侧拉到更大的血管内。 37. A method according to claim 35 or 36, comprising prior to said extraction means to remove the catheter the device is pulled proximally within a larger vessel. 3S•根据权利要求32至37中任一项所述的方法,包括拧绕所述装置以将所述装置嵌入血栓内。 3S • The method of any one of claims 32 to 37, said means comprising a threaded about the device is embedded within the thrombus.
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